Respond

It is crucial that this decision, and the communications surrounding it, be handled in a well-planned and systematic fashion.  Just today, our manager walked into the office that five of us share and stated that a sixth person would be joining us.  I have learned that change is constant in our department, and people are shuffled all over as space permits; however, one of my office-mates angrily said, “he really could have told us before bringing in the sixth person and announcing that she would be joining us”.  It was a good example of how staff feel about poor communication.

Moreland and Apker (2016) note that nurses feel excluded when leaders inconsistently communicate policies and don’t invite feedback or input into decision-making.  Therefore, as the nurse administrator, I would prepare a plan to communicate the difficult decision to eliminate tuition reimbursement benefits.

First, I would explore the reasons why the decision was made.  Was it cost-prohibitive to maintain?  Did staff obtain tuition reimbursements, only to leave as soon as they received their BSN or MSN?  Did it engender annoyance from staff who already had their degrees and could not take advantage of the benefit?  I believe that transparency is best when communicating a change in policy.

Next, I would do my best to inform all direct reports at the same time, perhaps in a meeting.  There are few things worse in an organization than for the information to get “leaked” by a few people, and then turn into a rumor with untruths.

Before I tell the direct reports, I would have an email/text/snail mail document prepared, so that all staff could receive it before the rumor mill starts.  Having a written form of communication allows me to control the message and get all the pertinent points noted.  The document would end with an invitation for all staff to contact me if they have any questions or comments.  Being accessible to staff would, I hope, create some good feelings to offset the loss of tuition reimbursement. 

1. Length – 750 – 1,000 words, excluding title page and reference page.

2. Word Processing Format – Microsoft WORD is the required file format using APA, Times New Roman, font of 12; (6th Ed. Publication Manual of the American Psychological Assoc.) This assignment requires an Abstract.

3. APA issues – one point will be deducted for each APA issue, please use your APA resources, for correct formatting of APA. 

Indeed, today’s nursing environment has exposed nurses to many reasons to be conflicted.  For instance, some patients declare wishes to be permitted to die with dignity and request that their wishes are respected. Others may wish that their life support is terminated. It can also involve actions like nurses taking two tablets of oxycodone as ordered but keeping one for herself. From a biblical point of view, I feel it is wrong to help a patient die with dignity. However, from a professional point of view, nurses must advocate and support the patients’ decision including one to make their own decisions.  Making decisions in such a situation can cause ethical dilemmas. Having not come across such a situation, I can comment that it is essential for nurses to familiarize themselves with legal and moral issues surrounding the issue (Smith et al., 2016).

Also, in these cases, nurses should possess a basic understanding of the scope of practice and standard of care. Also, they should refer to the code of ethics for nurses with interpretive terms like beneficence, justice, and autonomy. For example, the law permits it and a person (an adult) has the right to be assisted to die at his or her request especially they are terminally ailing and in unmanageable pain. Also, sometimes life-sustaining therapies may prolong suffering at the cost of decreasing the patient’s quality of life. Besides, nurses caring for the patient at the end of life have a professional and moral obligation to follow guidelines depicted in ethical and professional standards (Dahlqvist et al., 2016). Most importantly, nurses should advocate ascertaining the goals of their patients are met while following principles.

Please respond to the discussion above

 please, write response to the following discussion by using one reference from peer-reviewed Nursing Journal not older than 5 years.

Regulation

      The healthcare profession has numerous regulatory bodies ensuring patient safety is maintained at a high standard.  One such organization is The Joint Commission (TJC), an organization established in 1951 that provides voluntary accreditation through a very in-depth evaluation of compliance with standards of care of an organization (Wrzesniewski, 2017).  Continued accreditation establishes an organization’s determination to provide evidence-based, safe, quality care.  In 2001 TJC introduced a new requirement of a formal patient safety program (Huber, 2018).  The continuously elevated level of standards and safety measures required by TJC ensures safety is always at the forefront of health care.  Although medication administration error goals can be to keep errors to a minimum, it is impossible to avoid errors where the human element exists (Wang et al., 2015).  Hospitals can establish the building blocks needed to provide care of the highest standards through the safety framework required by TJC accreditation.  However, to assure continued safety and compliance it is important as a hospital culture to maintain standards and not push staff compliance before inspections (Wrzesniewski, 2017).  The standard of care and safety measures should be instilled in healthcare workers.  Policies and procedures should be adhered to and followed to the letter to avoid staff confusion and straying from the goal of safety.  Safety in an organization is a culture and must be preserved at its highest form. 

As nurses, we follow organizational policies and procedures, question when necessary, and advocate for change when applicable. Nurses are the last line of defense in medical errors.  This responsibility should not be taken lightly and a conscious continuous effort should be made to apply evidence-based practice when providing care to patients.  Patient safety should be the number one priority in any health care and to any given healthcare provider as we have all taken an oath to above all not do any harm to our patients.       

 Social determinants of health refer to social and economic factors that specific individuals have to deal with because of birth, status, gender, culture, race, income status, employment, physical surroundings and access to health services (Government of Canada – modified 2019).These determinants influence the behavioural and risk factors of individuals within specific geographical neighbourhoods.

     Low income and culture are two of the many risk factors for diseases. Because of the lack of proper education, there is lack of knowledge that is essential to promote and prevent diseases and restore health. Culture plays a role because of traditions, customs and beliefs, the family may not think, act or feel the same way about their overall health.

    The communicable disease chain model is a means of addressing the different transmissions that happens when the agent leaves it host (reservoir – human or animal or the environment such as mosquitos in stagnant water, poor air quality) through a portal exit and enters via transmission through a portal entry to infect a susceptible host. “Th emode of transmission is th emeans of the agent’s travel from the portal of exit to the host” (Green, 2018). This sequence is usually referred to as a chain of infection. If there is a break in the chain of infection, then it is aborted.  For a community that is already at risk because of social determinants of health it is important that diseases are addressed promptly to avoid the widespread infection. For example, in a nursing home where there are less workers and many patients, a staphylococcus bacterium, such as methicillin-resistant Staphylococcus aureus (MRSA) can be passed easily via a source to a susceptible host. In order to avoid this transmission, proper handwashing is necessary before and after patient care to abort or prevent this chain of infection.

References