Clinicals Week 6

For the week of 10/19/09, I spent a total of 3 hours with my preceptor. One of the main things that we did was to attend a Discharge Planning Task Force meeting. On the Rehab Care Unit, they have been having problems with getting the patients discharged in an organized manner. They want to make sure that all loose ends are taken care of before the day of discharge so that families only have to worry about going home on discharge day. This involves physicians writing the appropriate orders in a timely manner, nursing, rehab, and respiratory therapy making sure that all of the education and rooming in has been appropriately done and documented, and case management arranging for all of the home care and equipment. So, many disciplines were present at this meeting. They decided to start having discharge conferences including family, once they have a tentative DC date. They also decided to update the kardex to show all completed education and roomings in. Lastly, they decided that they needed to have written criteria to determine a successful rooming in.
It was great to see all of these people working together and how much could be accomplished when getting everyone in a room together.

Clinicals Week 5

This week I spent 5 hours with my preceptor. I attended many meetings with O.C. I attended a leadership meeting for the rehab and transitional care units that he directs (RCU & TCU). The patients on these units are often in the hospital for a very long time while patients go through rehab and families learn to care for them. In this meeting, it came to light that the managers for these units are having a hard time getting patients discharged in an organized manner. The charge nurses are often having to chase down doctors and nurse practitioners for orders and have a really hard time scheduling rooming in and discharge conference. Also, the case managers were having trouble getting the info that they need to get the days paid for by insurance. This was very interesting. O.C. used a formula that he learned in grad school for identifying and beginning to solve the problem. He went over this method with me after the meeting. I think this helped me with my goal of learning to deal with conflict in the workplace.

On a side note, these last couple of weeks have been so hard for me. My kids have been sick and work has been crazy. I can't seem to keep up. I am just trying to tackle small chunks at a time. If anyone else is having any of these same obstacles, please know you are not alone! We can do this together!

Clinicals Week 4

This past week I spent 6 hours with my preceptor. We did many things, but one meeting stood out as very interesting to me. We went to a nursing executive professional organization meeting. They had a speaker that was a high level nurse exec for one of the local hospitals. She gave a presentation about unions in nursing. This was a very interesting topic to me because growing up in Texas, I don't feel like I know a lot about unions. She explained how many people think that Texas is very vulnerable to union movements right now. She also explained a lot of the tactics that unions and hospitals use when a union tries to come into the organization. I found it all interesting, but I think that her presentation seemed pretty right wing biased. I am more liberal in my views, so I would love to get some other people's views on unions in nursing. From her point of view, it did not sound like a good thing at all. But, I don't like to just believe anything I hear. I need more info before deciding what I think.

Clinicals Week 3

This week I spent a total of 8 hours with my preceptor. It seemed that this week brought about a lot of crisis management. The hospital is extremely busy, especially the ED, due to the flu. This burden is therefore dispersed throughout the medical center. This placed extra pressure on the floors that my preceptor directs. They needed to be able to care for extra patients and make sure that patients were being discharged when possible to keep patients moving through the ED. It also posed a problem because the occupational health department director is being very active in preventing flu outbreak among employees. Occupational health is screening employees and asking them to stay home when they meet certain criteria. This makes staffing difficult for this very busy patient load. O.C., my preceptor, stayed very calm in all situations. He was very good at evaluating the situation at hand and making appropriate decisions to ensure patient and staff safety. I was very impressed by his strategic decision making and his ability to also consider future outcomes.