NURS6341 Discussion Response #4: Analyzing Patient Risk 2025

NURS6341 Discussion Response #4: Analyzing Patient Risk Respond to the discussion #4 below using the following approach: Offer and support an additional strategy a colleague might use to integrate the principle of stacking into his or her specialty of interest. Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. Ask a probing question, substantiated with additional background information, evidence, or research. Discussion #4 As the acuity level of our patient’s health status increased, the complexity of our roles increases also. Attempting to manage multiple patients with complex health statuses requires the nurse to develop a care giving rubric that allows for this complex decision making process to occur seamlessly, with no harm coming to our patients. As novice nurses this task can seem daunting and overwhelming at times, but as we process through our career, the clinical decision making matrix becomes much easier to perform. One of those decision-making matrixes is stacking . Stacking is an RN cognitive process involving decision-making about workflow priorities (Shirey, Ebright, & McDaniel, 2013). Stacking as an important strategy used by experienced RNs for management of the complexity surrounding nursing care which involves complex reasoning and clinical decision making. My clinical setting for my example is the Operating Room (OR) of a large hospital. As OR nurses, it can be overwhelming even for a seasoned OR nurse to understand, and prioritize this complex, multifaceted environment. Being a high pressure environment, the OR can be a very fast-paced, stressful place. Surgeons’ tempers can run high, and that can trickle down to the staff, placing more emphasis on creating smooth running process, by the OR RN. Eskola et al. (2016) noted that the OR can be a stressful practice environment, where nurses might have either job stress or job satisfaction based on their competence. In my clinical example, the building was built in the early 1900’s with many, many additions over the years. In the Operating Rooms suites, their locations were scattered on 3 different wings of the hospital, and on 2 different floors. In addition, the Central Supply, which sterilized and stored the surgical instruments and disposable supplies, was located in the basement of the original building, requiring multiple elevators trips to gather supplies. Also, the elevators were not dedicated to the OR’s, but were general use elevators, which made timely delivery of supplies problematic. In this environment, the OR nurse needed to be very skilled in stacking, as regards to equipment and supply prioritization and optimization of use. In today’s hospital culture of, “just in time” supply delivery, many hospital items are not stocked in large quantities and so amassing of large quantities of possibly needed equipment and supplies was frowned upon. The prioritization skills of the novice nurse would have been taxed as even the more experienced nurses found the ability to have the correct supplies, in the correct quantities, in addition to planning for the unforeseen issues, daunting in the best of circumstances, and overwhelming in the worst of situations. Yildiz Findik, Ozbas, Cavdar, Yildizeli Topcu, & Onler (2015), remarked that the nursing students generally employed a helpless/self-accusatory approach among passive patterns as their clinical stress levels increased, and those who had never been to an operating room previously used a submissive approach among passive patterns. In this environment, emphasis must be placed on the prioritization decisions in preparing and stocking supplies, and in the relationship management with the physicians. For example, in cultivating a high relationship management technique with the operating the physicians, the OR nurse was better able to anticipate needs and have the correct items available, when they were needed. Patterson, Ebright, & Saleem (2011) said that in particular, being proactive on certain tasks was believed to reduce the overall amount of time spent on them. Being proactive in the OR environment requires a certain level of self confidence in the ability to communicate information quickly, concisely and accurately. References Eskola, S., Roos, M., McCormack, B., Slater, P., Hahtela, N., & Suominen, T. (2016). Workplace culture among operating room nurses. Journal of Nursing Management , 24 (6), 725-734. doi:10.1111/jonm.12376 Patterson, E. S., Ebright, P. R., & Saleem, J. J. (2011). Investigating stacking: How do registered nurses prioritize their activities in real-time? International Journal of Industrial Ergonomics , 41 (4), 389-393. doi:10.1016/j.ergon.2011.01.012 Shirey, m. r., Ebright, p. r., & McDaniel, a. m. (2013). Nurse manager cognitive decision-making amidst stress and work complexity. Journal of Nursing Management, 21(1), 17-30. doi:10.1111/j.1365-2834.2012.01380.x Yildiz Findik, U., Ozbas, A., Cavdar, I., Yildizeli Topcu, S., & Onler, E. (2015). Assessment of nursing students’ stress levels and coping strategies in operating room practice. Nurse Education in Practice , 15 (3), 192-195. doi:10.1016/j.nepr.2014.11.008 Reminder: 1. 1 page only 2. Put Citations in APA format and at least 3 references… Articles must be 2011 to 2016. Required Readings Ebright, P. R. (2010). The complex work of RNs: Implications for healthy work environments. The Online Journal of Issues in Nursing, 15 (1) Retrieved from the Walden Library databases. The author, an expert nurse, examines the meaning of “complexity” in nursing practice, how complexity impacts safety, quality, and retention, and considers recommendations and solutions for addressing complexity to reduce nursing stress and improve patient care. Duffield, C., Diers, D., O’Brien-Pallas, L., Aisbett, C., Roche, M., King, M., & Aisbett, K. (2011). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, 24 (4), 244–255. Retrieved from the Walden Library databases. This article details a study that links nurse staffing issues, increased workload, and unstable nursing unit environments with negative patient outcomes, including falls and medication errors, on medical/surgical units. As you read, compare the concept of nursing workload and nursing complexity and consider solutions in the Ebright article that might apply. Required Media Laureate Education (Producer). (2013). Addressing complexity of nursing practice [Video file]. Retrieved from https://class.waldenu.edu . Note: The approximate length of this media piece is 8 minutes. In this video segment, Dr. Pat Ebright and Dr. Mary Sitterding discuss complexities of nursing practice. Specifically, they highlight how the principle of stacking can help both novice and experienced nurses to make key workload decisions in the clinical environment. Accessible player Laureate Education (Producer). (2013). The role of the nurse educator [Video file]. Retrieved from https://class.waldenu.edu . Note: The approximate length of this media piece is 9 minutes. In this video segment, Dr. Pat Ebright and Dr. Mary Sitterding discuss the role of the nurse educator.

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NURS 6221: MANAGING HUMAN RESOURCES – Discussion 10 (Grading Rubic and Media Attached) 2025

Discussion: Creating, Developing, and Leading Effective Teams Coming together is a beginning. Keeping together is progress. Working together is success. —Henry Ford A critical skill for all nurse managers is the ability to create, develop, and lead effective teams. When people are part of an effective and well-functioning team, they are more productive and have a stronger commitment to the organization. Nurse managers have a responsibility to create teams that fulfill functional needs within their units or departments. These can include leadership teams, ad hoc project teams, or primary work teams. As a nurse manager, there is a variety of ways that you can enhance team functioning. The first step is developing the structural elements of the team and then designing the team with the appropriate membership. Just as you must critically examine each application during the employment process, so will you critically examine the skills and attributes of each employee before appointing him or her to a collective team. In this week’s Discussion, you lay the groundwork for creating and developing a team for your unit, department, or health care setting. You also identify leadership strategies that you could employ to increase the team’s organizational effectiveness. To prepare Review Chapter 5, “The Art of Effectively Facilitating Processes” from the course text, From Management to Leadership: Strategies for Transforming Health Care. Carefully examine the section, “Essential Elements of a Team” to identify the six steps of creating an effective team. Consider a team you might create for your current organization or one with which you are familiar. For example, is there a project to be accomplished or a problem to be solved? Perhaps there is a need for a leadership team within your unit or department? Identify the purpose or goal for your team. Then, reflect on the following questions: What type of team would you create (leadership, ad hoc, or primary work team) to accomplish this purpose or goal? What are the benefits or disadvantages of creating this type of team? What staff members would you want on this team? Why? How could their skill sets and positions make them effective team members? Explore this week’s Learning Resources to identify leadership strategies you might employ before, during, and after the team-building phase. For example, what leadership strategies might influence synergy among team members while also increasing the effectiveness of the team? Post a description of the team you would create, including the purpose or goal the team would serve, the team type, and the specific skills each member would contribute as well as their job positions. Describe at least two leadership strategies you could implement to help this team effectively achieve its purpose or goal. Read a selection of your colleagues’ responses. Respond to at least two of your colleagues on two different days using one or more of the following approaches: Critically appraise a colleague’s team description. Provide an additional leadership strategy he or she could use to further improve the effectiveness of the team. Find a colleague who would like to implement a team similar to one that has been implemented in your workplace. Share an insight into how your organization benefited from this type of team and the leadership strategies management employed to support the work of the team. Required Readings Manion, J. (2011). From management to leadership: Strategies for transforming health care (3rd ed.). San Francisco, CA: Jossey-Bass. Chapter 5, “The Art of Effectively Facilitating Processes” (pp. 179–242) This chapter describes the many components that make up the facilitating process. Some of these elements include empowerment, authority, resolutions, and negotiation. Chapter 6, “Getting Results” (pp. 243–282) The main points of this chapter are the components that contribute to effective teamwork. The author lists the benefits and pitfalls of proactive behavior, group decision making, and problem solving. Beeson, J. (2011). Build a strong team. Leadership Excellence, 28(2), 15. Retrieved from the Walden Library databases. Beeson’s article focuses on the importance of building a structured team. He provides five steps that leaders can implement in the workplace to create a strong team that benefits the whole workplace. Calendrillo, T. (2009). Team building for a healthy work environment. Nursing Management, 40(12), 9–12. Retrieved from the Walden Library databases. In this article, Calendrillo states that skilled communication is the foundation for strong team building in clinical settings. When skilled communication has been mastered and used, quality patient care and healthy work environments are among the many results. Pentland, A. (2012). The new science of building great teams. Harvard Business Review, 90(4), 60–70. Retrieved from the Walden Library databases. This article addresses how communication is a key to team efficiency. The author provides three communication dynamics that were used by the teams that were most communicative. Required Media Laureate Education, Inc. (Executive Producer). (2012). Team building. Baltimore, MD: Author. Note: The approximate length of this media piece is 8 minutes. This week’s presenter, Jo Manion, provides effective team-building strategies nurse managers can employ when initiating teams in units, departments, and organizations. She also reviews the three types of teams that are generally found in health care settings: leadership, ad hoc, and primary work teams. Accessible player The following document gives credit for Laureate-produced media in this course: Credits (PDF) Optional Resources Ramsay, S., Troth, A., & Branch, S. (2011). Work-place bullying: A group processes framework. Journal of Occupational & Organizational Psychology, 84(4), 799–816.

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