NR 393 Week 1 Discussion: Reflection on Leadership and Provision of Care (Graded)

In this week’s discussion post we are to reflect on our current nursing practice and think about how nursing history has impacted our leadership and care provisions. When I think about my nursing practice, I am told by colleagues that my nursing practice is compassionate, caring, good at delegating and that I enjoy sharing knowledge and teaching. When I think about specific nursing history and or event that reflects my current nursing practice, I think about an example I found in the textbook. According to Judd (2014), “Koloroutis (2004) has developed a model of caring for nurses and organizations. It is based upon the assumption that caring relationships significantly impact nurse-patient outcomes” (p. 16). Judd (2014) further explains Koloroutis’s model is broken down into three realms: delegated practice, independent practice to promote health and healing, and interdependence practice with communication with other healthcare members (p. 16). I work in a busy emergency room and I feel that Koloroutis model is definitely practiced every day. For the emergency room nurse to be successful the nurse needs to be able to delegate, work independently, and communicate well with a variety of team members. At my facility a single trauma patient requires the following members to function as a team: physician, trauma surgeon, two to three nurses, trauma technician, Xray tech, CT tech, phlebotomist, lab tech, pharmacist, and emergency medical technicians/paramedics. If possible, I always like to have a quick meeting before the trauma patient arrives where I delegate tasks, set boundaries/expectations from the team, and formulate a game plan. I have found this strategy to be very successful in most cases.

I was not always 100% interested in becoming a nurse. I did grow up in a Lutheran school and was raised from Kindergarten on to follow in Christ’s footsteps. I cared for my grandmother naturally as she was disabled; helping her to dress, rinse off in the shower, or wash her hair in the kitchen sink. My family called me ‘Nurse Kelly’ when I was young. I changed my mind several times on what I wanted to do, but I always wanted to work in a helping field. Eventually, I chose nursing again as I felt it made sense in my life.

I thought it was interesting that St. Basil, Brother Gerard, and St. Camillus were fathers of nursing teaching us the value of advocacy and caring for the poor, hands on work, but also St. Camillus was the founder of hospice care which is one of the areas I work in. Caring for the sick and dying and promoting their quality of life in their end times is one of the most gratifying areas of nursing. 

Learning more about the foundation of current nursing practice, I feel more like the field suits me. You certainly do not have to be a Christian to be a nurse, but the foundation of Christianity is supposed to share the level of compassion and care that nurses give to their patients every day. I firmly believe I would have likely chosen to become a deaconess back when women were offered education for their commitment – maybe with a lowly alternative of just becoming someone’s wife, I would have chosen the commitment of serving others while my needs were met and having freedom to continue my faith as well as the option to return to my parents and marry later.

I had no idea that Florence Nightingale visited the Deaconess hospital and that she was impressed with the level of care or that this is how nurses began being required to test into the field. I learned a lot from this section already about nursing history and feel more-so that the field fits my attitude towards others.

NR 393 Week 1 Discussion: Reflection on Leadership and Provision of Care (Graded)

Purpose:

The purpose of this reflection is for learners to reflect on current practice and the impact that nursing history has on their leadership and/or provision of care.

Course Outcomes:

This reflection enables the student to meet the following course outcome:

CO1: Describe persons and events in nursing history from the early years through the 19th century related to leadership and provision of care. (PO2)

Due Date:

Answer post due by Wednesday 11:59 PM MT in Week 1
Two replies to classmates and/or instructor due by Sunday 11:59 PM MT at the end of Week 1

Points Possible:

50 points

Directions:

Reflection is an activity that involves your deep thought into your own experiences related to the concepts of the week. Answers should be detailed.
Use the rubric on this page as you compose your answers.
Scholarly sources are NOT required for this reflection.

Reflection Question

Reflect on your current practice. How does nursing history impact your leadership and/or care provision? Please include specific nursing history persons or events in your reflection.

Grading:

To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.

Class,

Nursing history is all around us. In addition to the stories of nurses who came before us, we are also making nursing history today along with our colleagues. Think about your own leadership and/or provision of care and then reflect on how nursing history impacts one or both of those areas for you. Tell us the specific historical nurses or events that most impacted your leadership or provision of care.

I look forward to reading your reflection.

In the early 19th century and before, nursing was done by persons, not a licensed nurse, as they did not exist, to usually make the sick comfortable before their passing.  Helping someone with comfort, kind words, or a gentle touch is timeless.  Today, this is something carried forward that I provide in nursing care.  There are times that I have a patient that is passing, and as in the past, the best that I can do for them is to provide care and comfort until the end. 

I have seen in history, pictures, and movies, as well as the patients have seen, the good light that nurses are portrayed in.  I try to be a good role model as a nurse.  Patients look to me for caring feelings, physical care, and information.  Besides being there for someone who is passing, today I use evidence-based practices in nursing care that has evolved over the years, and I teach patients about preventative care.  I learned from our readings that a lot of the nursing care provided in the past was mainly done by men.  This was surprising information to me, as there were only two men in my nursing class.

Florence Nightingale is known as a caring nurse in history and has contributed to the nursing profession in many ways, such as with education, being an advocate, and research.  Just as Florence Nightingale was a nursing researcher, nursing research continues today, and I can apply new discoveries or new methods in delivery of care in my practice, as well as use this information to educate my patients.  Some of the things that Florence Nightingale spoke about in the past also impacts my nursing practice today.  They include confidentiality, building trust, observation, communication skills, and cleanliness.  These items are all necessary in the nurse-patient relationship. 

Licensed nurses, like myself, go through schooling as in the past, to receive their knowledge base.  As time goes by and I am working, I am always learning something new.  History is always changing and impacting my performance and knowledge, and with new technology it can even be daily.  Some things, like caring, compassion, and empathy, do not change over time, but impact the way I view nursing.  Something as small as a smile, can change a patient’s day.

As you progress through this course, I think you will appreciate how treating the mind, body and spirit that has been integrated into nursing practice from the historical nurses that you will learn about.

I enjoyed reading your post because I feel that you really boiled down the main point. We all go into nursing for different reasons, but at the heart of it should be the desire to help others. This can be done in so many ways, and nursing recognizes that healing comes from many angles, which is why it is spoken of as “holistic”. Nurses are thought of very warmly by so many people, because the very nature of it is someone who cares about you and will take care of your needs. I think we all have that quality, and bringing it into your work is what nursing is all about. No matter what changes, the technology, methods, science… the caring nature of this profession never does. I often feel like I have done more good by holding my patient’s hand and talking to them than anything else. Florence Nightingale is a perfect example of this because she wasn’t satisfied with leaving things just as they were! She advanced the profession because she truly cared about her patients, and I hope we all can too.

Great post!

I really enjoyed your post. At the end of one’s life, there can be so many questions, feelings, uncertainties, especially with the family. I love that you addressed the nurse’s importance of just being there, to help keep their loved one comfortable, to answer questions or concerns, as well as just be that extra person to give that family support. As an SNF nurse, I have been in the process of many patients passing, both expectedly and unexpectedly. The end of life can truly be a scary thing for families who don’t know what is going on, and for there to be an educated, respected, and caring nurse there can make a world of difference. Like you said, sometimes the simplest actions, such as a caring smile, can change someone’s entire day around. 

One of the things that I find most rewarding about my job is when I have a moment with a patient where I feel like I made a difference. I always try to look at the situation and think to myself that they have no idea what is going on and most of the time our patients are anxious over the unknown. Even something so simple as running an EKG is terrifying because they want to know why its being done, is it going to hurt, what does the result show, among many other questions when we as healthcare professionals know it could just be as a reference pre-op or to see if their lab values are impacting their heart at all.

I enjoy when I get to essentially sooth their anxiety through talking to them and educating them on what it is used for so they don’t worry about their health. I also enjoy when I can give family members peace of mind about their loved ones and let them know that everything is going well or give them updates about their conditions. Communication is such a key part of our job because it allows us to successfully take care of our patients and provide positive outcomes. We are the ones who are with them for extended periods of time and taking care of them so its so important that we keep them involved in their care.

“Skillful communication is related to improved health care outcomes, such as patient satisfaction, therapy compliance, symptom resolution, and physiological parameters or improved health status” (D’souza, Devi, and Sheilini, 2013). Taking care of patients is not just doing all the tasks of nursing but also being there and providing emotional support. Nursing history has taught us that nurses are an incredibly valued and trusted profession and that is because we are the ones who are there for our patients emotionally and physically and that is one thing that will always be at the foundation of our profession.

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Reference:

D’souza G., Devi E., Sheilini M. (2013). Communication Pattern, Attitude Towards Importance of Communication and Factors Affecting Communication among Nursing Graduates Working in Cardiac Units. International Journal of Nursing Care.

  Thank you for having compassion for the end of life. We have always learned that the hearing is the last to go and I truly believe this is true. I have to remind myself of this at times when patients are being intubated in emergency situations and also at the end of life. Just last week I had to honor to be with a family who was saying goodbye to their mother after a spontaneous brain bleed while having dinner with her family. Sometimes the nursing care has to extend onto the family of the patient as well. I hope and pray that I brought peace of mind to them while they were singing and saying their goodbyes. Good luck with this course!

I was not always 100% interested in becoming a nurse. I did grow up

in a Lutheran school and was raised from Kindergarten on to follow in Christ’s footsteps. I cared for my grandmother naturally as she was disabled; helping her to dress, rinse off in the shower, or wash her hair in the kitchen sink. My family called me ‘Nurse Kelly’ when I was young. I changed my mind several times on what I wanted to do, but I always wanted to work in a helping field. Eventually, I chose nursing again as I felt it made sense in my life.

Thank you, 

Thank you for referring to deaconess. We don’t often think of nursing has a service industry but we provide a service to individuals in the most vulnerable situations. I believe that is what makes nursing stand apart from other professions of service. 

My experience as a nurse reminds me of  Florence Nightingale. Florence Nightingale was the first emergency nurse. She revolutionized nursing, basically set the blueprint for nursing practice.  She is the guide to all nurses of how we should be and what we should strive for as nurses. In my nursing practice, I always look for evidence-based guidelines when I am caring for my patients. I question current practices, and I use critical thinking, intuition, and follow my heart. I seek knowledge in books and from my experienced peers.

I compare my work practice from my shifts, and I find better ways to be better the next shift. I am always thinking, what can I do better today? How can I provide better care for my patients today? I believe every time I care for someone, every time I save a life, educate, prevent, inspire, and touch, I am making history. I have so much in my power, especially when I am working as a relief charge nurse to help all the patients I come in contact with.

Today Nurses run the hospital. With today’s evidence-based practice, we have the tools and knowledge to provide the safest and compassionate care to our patients. When I have made a difference in someone’s life, that’s a piece of history. I believe that helping patients and educating them on preventive care, and helping them be more compliant can be great for generational health. Educate families you give the power to help themselves.

I would say that my current nursing practice at the core is not that much different than what it was at the founding of nursing. The profession started because of a need for those in communities to take care of each other especially those who fell ill. My job at its core is to take care of people who are sick and not able to take care of themselves. Based on the lesson talking about ancient nursing, it is apparent that nursing (even though it was not yet called nursing) was about taking care of those in need by providing caring and comforting measures (CCN, 2020). Nursing history impacts our care because it is the founding of our profession.NR 393 Week 1 Discussion: Reflection on Leadership and Provision of Care (Graded)

It seems crazy to think about now, but modern nursing once you branch out from the core is much different than ancient nursing because we have adapted and modified over the years to suit our changing communities. We are much more involved in treatment and interventions than we were at the beginning because we focus on how to keep our patients safe and prevent illness versus just nursing those who are ill. Nursing history is the reason for many changes that have occurred over time but one of the largest ones I value is patient autonomy which was derived from Lydia Hall’s nursing perspective.
Lydia Hall is the pioneer of patient autonomy which is “to help the patient determine and clarify goals and, with the patient, work out ways to achieve the goals at the individual’s pace, consistent with the medical treatment plan and congruent with the patient’s sense of self” (George, 1995, p. 88). Patient autonomy is when we give the patients the ability to have a say in their care and allow them to ask questions and work together towards a common goal. This is different from the beginning of nursing because modern nursing started during the war time with Florence Nightingale so it used to be critical nursing where survival was the goal.

Once the war time nursing was transitioning to modern nursing it became apparent that we must take into consideration that patients should have a say in their treatments and should be allowed to ask questions regarding their treatment. Without Lydia pioneering autonomy we might still be in the routine of treating but not collaborating which would have poor outcomes if the patients and doctors were not on the same page. As a modern day nurse I know the importance of autonomy and collaborating with both patients and those of the treatment team so that we can all work towards a common goal and provide the comfort and caring environment that is at the core of nursing.

References:

Chamberlain College of Nursing. (2020). Week 1 lesson. Retrieved from: https://chamberlain.instructure.com/courses/71197/pages/week-1-lesson-in-the-early-years?module_item_id=10093942
George, J. B. (1995). Lydia E. Hall. In J. B. George (Ed.), Nursing theories: The base for professional nursing practice (pp. 87-97). Norwalk, CT: Appleton & Lange.