Directions:

Nurse Leader and Manager Decisions

Nurse leaders and managers and are responsible for making decisions in the healthcare setting.

First Post

Describe how you will be involved with the decision-making process using the DECIDE model. Include an example from a clinical situation you experienced in the healthcare setting.

Reply Post

Respond to at least one of your peers about their example that illustrates their interpretation of DECIDE. Expand on your peer’s ideas.

Note:

• “Expand on your peer’s ideas” needs more than 1 – 2 sentences for an acceptable reply.
• If you refer to a website or article, be sure to cite it in APA format. This prevents plagiarism and allows your fellow students to review the cites and increase the class knowledge base.

Please make your initial post by midweek, and respond to at least one other student’s post by the end of the week. Please check the Course Calendar for specific due dates.

1 RESPONSE1)

D = define the problem

(2) E = establish the criteria

(3) C = consider all the alternatives

(4) I = identify the best alternative

(5) D = develop and implement a plan of action

(6) E = evaluate and monitor the solution and feedback when necessary.

I will be a part of the decision-making process by participating in each phase of the DECIDE model. In a clinical situation, such as when a patient refuses to take medicine, I would first define the problem or opportunity. The challenge in this situation is that the patient is refusing to take his or her medicine, and the opportunity is to find a way to persuade him or her to do so. After that, I would make a list of objectives for myself. In this case, the goal would be to persuade the patient to take his or her medication. Then I would consider alternative possibilities.

After considering the options, I would set the criteria. In this situation, the severity of the patient’s sickness, the medication’s side effects, and the patient’s preferences must all be considered. When the criteria have been established, I will evaluate the options. When assessing the possibilities, in this case, I would evaluate the severity of the patient’s sickness, the medication’s side effects, and the patient’s preferences. After analyzing the possibilities, I would choose the best option. In this case, speaking with the patient about why they need to take their medication or offering them a new sort of drug could be the best solution.

In a clinical situation when I was dealing with a patient who was having problems taking their prescription, I used the DECIDE model. I started by determining the problem, which was that the patient was not taking his or her medicine as prescribed. Following that, I gathered data by conversing with the patient and their family to understand more about their condition.

Finally, I evaluated the plan’s outcomes by communicating with the patient and their family to see whether the education was helpful, as well as with the case manager to see if the referral was helpful.

Reference:

Guo K. L. (2008). DECIDE a decision-making model for more effective decision-making by health care managers. The health care manager, 27(2), 118–127. https://doi.org/10.1097/01.HCM.0000285046.27290.90

write a virtual clinical practicum  

This week learning was based on ECG.I learned through a EkG simulation game called “skulls stats game” and educational videos to practice and learned how to identify 27 of the most common cardiac rhythms, causes and treatments.  9:00 am – 11am : I learned about the normal values of a 12 lead ECGsuch as the P wave, PR interval, QRS  interval, St segment, T wave and QT interval .First,  itis important to determine the rate, and whether it is regular or irregular . I was able to  use the calipers to  track the  P waves and QRS complexes. I was able to demonstrate accurate measurements of heart rate, PR intervals, QRS width, ST segments and QT .  11am-1pm. I learned and was able to identify the basic principles of ECG lead placement and selection. I learned that having both good skin contact and adequate conductive jelly in the center of the electrode will help assure a good ECG signal is received. The ECG electrode conductive jelly typically dries up within two to three days. It is important to  Remove hair prior to applying the electrode. Clean the  sweat  and any bodily fluids from the  skin and use a dry towel to mildly scrub the skin before electrode application (Jones, 2008).  1:00pm-3pm: I learned to identify rhythms including sinus, atrial, junctional, ventricular, AV blocks, and paced rhythms along with characteristics, causes, clinical significance, and interventions for each. For instance in Afib there is no p- wave and the atrial electrical activity is very fast and possible causes can be copd,mitral valve disorders, Cad, digoxin toxicity.  First thing. the nurse need to assess the patient and check the patient Blood pressure as a result of a loss of atrial kick also,  the patient may experience some heart palpitations as a result of rapid heart rate , possible treatments before attempting cardioversion are anticoagulants to prevent embolic complications, diltiazem, digoxin, amiodarone to control the ventricular rate .    3pm-5pm: I learned to identify the lethal cardiac rhythms such as PEA. V-fib , V-tach , Asystole , how to assess the patient, when to call the code and what possible treatment to expect. For instance in V-fib the ventricle are not contracting and the patient will not have a pulse, blood pressure or cardiac output. Possible causes could be acute MI, electrolytes imbalances, it is imperative for the nurse to prioritize that patient and check for an airway, breathing, and pulse per Basic Life Support (BLS) standards. Call for help if the patient is found  pulseless, and unresponsive. Begin CPR. VF treatment requires defibrillation. Resuscitation requires defibrillation and emergency drugs per ACLS VF guidelines. The sooner the patient is defibrillated, the greater likelihood of achieving spontaneous circulation. The longer the patient is in VF, the more difficult it is to convert the rhythm.    5pm-7pm. Review and summary of how to identify and interpret cardiac rhythms originating in the sinus, junctional, ventricular areas. Heart blocks and life threatening rhythms as well as nursing priorities and potential treatment strategies were also discussed with my preceptor.

Assignment 1

For this Assignment, you will explore your strengths and potential gaps based on the nurse leadership competencies provided. Review the competencies that best fit into your current nursing role (nurse executive competencies, system CNE competencies etc…). Reflect on potential goals you might set to improve as a nurse leader. You will also reflect on how this goal setting and self-examination will not only improve your nursing practice but also your healthcare organization.

Note: You do not need to pay for the Nurse Leader Skill Assessment at the end of the competencies list provided.

To Prepare:

• Review the nurse leadership competencies presented in the Learning Resources for this week. (https://www.aonl.org/resources/nurse-leader-competencies)
• Reflect on these competencies, and consider your own personal strengths and potential gaps in relation to these competencies.
• Consider potential goals for your leadership development in relation to the nurse leadership competencies presented.

The Assignment: (4 pages)

• Explain your self-assessment in relation to the nurse leadership competencies. Be sure to identify your strengths and potential gaps in relation to these competencies.
• Describe at least four goals for nurse leadership development that you would like to pursue, given the results of your self-assessment. Be specific.
• Explain why these goals are pertinent to your development as a nurse leader. How will developing these leadership competencies support your healthcare organization or nursing practice? Be specific.

Discussion Board 1

For this Discussion, consider the role of transformational leadership for change. Explore the need for transformational leaders, and describe experiences you may have had with these leaders. Additionally, analyze how these leaders might enhance quality improvement in healthcare organizations and nursing practice.

By Day 3 of Week 10

Post a brief explanation of the relationship between transformational leadership for change and the need for quality improvement. Share any experiences you may have of transformational leadership in your healthcare organization or nursing practice. Then, describe how you would recommend the application of project management approaches to support transformational leadership practices for the promotion of a quality improvement initiative in your healthcare organization or nursing practice. Be sure to include any short- and long-term milestones or goals associated with the quality improvement initiative described. Be specific and provide examples.

Discussion 2

For this Discussion, compare change management and change leadership. Reflect on the potential impact of leadership approaches on change, and consider how leadership may influence change in healthcare organizations and nursing practice.

By Day 3 of Week 11

Post a brief comparison between change management and change leadership. Be specific. Explain how leadership approaches may relate to processes for evaluation of and sustainment of change in a healthcare organization or nursing practice. Then, explain the function of leadership in evaluating, maintaining, and sustaining change. What is the influence of leadership on these aims? Be sure to include a brief explanation of whether you should stop measuring change in an organization, and explain why. Be specific and provide examples.

You work as a nurse at Lake Side Hospital in the emergency department. When you arrive at work, everyone was talking during shift change about a hostage situation happening less than 1 mile from the hospital. For over 12 hours, a man was holding eight hostages at gunpoint, including two small children. Later that shift, 5 trauma victims come in at once causing chaos in the ED. You are assigned to treat a man who was shot in the left shoulder and abdomen. He has no identification on him nor cell phone and during the chaos you don’t get much of his story besides his medical situation. Your trauma team treats, stabilizes him, and sends him to surgery. At change of shift, you hear fellow nurses talking about how that man you worked on was the hostage taker. They mention that his surgery went well.

You go home and start reading the local news. You find out that four hostages, including the two small children, died last night. You read as much as you can about the victims and feel your rage growing. You cannot believe that you helped save a monster like this.

Before going to bed, you post a link to the news article about the situation on Facebook with a comment that says, “I can’t believe I took care of this monster today. I hope he rots in prison. RIP little angels.” In the morning, you wake up and realize that post was a bad idea. You quickly delete it, and you notice no one has liked it or commented on it. You are so thankful that you only shared it with several close nurse colleagues who work at Lake Side Hospital. As you are getting ready for work, your manager texts you and asks you if you can come into work early.

When you arrive at work, your boss has a screenshot of your post. She tells you that you will not be working that day and the hospital has placed you on administrative leave while the investigation occurs. You try to explain to her that you just got so mad that this monster survived, and those two small children died, and you only posted it to a select group of fellow nurse friends who work in the hospital. You also tell her that you have deleted the post – so everything is okay now.

1. Do you think this suspension and investigation are justified? Why or why not? Please support your argument with the assigned readings and at least one scholarly article.

1. As the nurse manager of the ED, you decide to create a presentation for other staff members about using social media professionally. Utilizing the assigned readings and at least one more scholarly article, identify three key points you would make during the presentation. Please be specific.

1. Reflect on your social media usage. Based on the readings this week, are there any changes you might make to your own personal use? Why or why not?

Answers those questions after reading the articles: minimum 125-150 words per reflective answers