For the week of 11/23/09, I spent 7 hours with my preceptor. We attended the leadership meeting for the 6th floor, which is the rehab and transitional care unit. The leadership on this unit were having problems communicating. O.C. discussed the communication barriers with them. He also pointed out that they have different personalities that are contributing to the difficulty communicating. He was great. He stayed calm and neutral and was able to get each of the managers to see the other side of things. It was a very productive meeting and I think that the managers walked away feeling much more optimistic. They also had a newfound desire to try to communicate better with each other. It was a great learning experience for me since I am new to a management position.
My preceptor and I spent the rest of the clinical day discussing experiences during our time together. I got to ask him a lot of questions. This was my last clinical day and I truly feel like my experience was so enlightening. O.C. was a great preceptor and he taught me a lot!
Friday, November 27, 2009
Clinicals Week 10
For the week of November 16th, I spent 8 hours with my preceptor. We attended a lot of meetings. It really showed me how important it is to have time management. We went to three meetings and in between meetings we checked emails, took care of phone calls, and worked on ongoing projects. It was quite a busy day! The first meeting was about implementing computerized provider order entry (CPOE). Of course, this is a difficult process because providers tend to be resistant to these types of changes. But, after a long time of planning Cook Children's should have it fully in place by the end of December. The second meeting was for Patient Care Council. It was a director level meeting that is informational in purpose. Each director gave updates for their departments if they had any. And the last meeting was to plan the charge nurse workshop for the charge nurses on the 4th floor. They discussed the agenda for the workshop and who the speakers would be. They also discussed some case presentations that they would have for the charge nurses, one of them being a simulation of a code for a child that had apnea after receiving a narcotic. This is a great case for this pre and post surgical floor because it is a very real possibility that this could happen on this type of unit.
Sunday, November 15, 2009
Clinicals Week 9
I was unable to schedule any clinical time for the week of November 9th, due to conflicting schedules between me and my preceptor. I did, however. have to time to work on the evaluation for my change project. For my project, I implemented a cheat sheet/algorithm for the nurses to follow for a complicated test that they do on their unit. The orders were very hard to follow and the nurses had made multiple errors on multiple occasions. My preceptor and his nurse managers tell me that the tool was very well received by the nurses on the unit. I plan to ask each of the nurses to fill out an evaluation of the tool and to find out if it was helpful for the nurses that were able to use it.
Clinicals Week 8
For the week of November 2nd, I spent a total of 5 hours with my preceptor. I accompanied him to multiple meetings. We went to a Respiratory Therapy Leadership meeting. O.C. is invited to this meeting because he is the director of the Rehab and Transitional Care Units where many patients have trachs. This meeting was pretty mundane, but I did notice that some of the RT's seemed to lead the group more than others, regardless of their titles. My preceptor and I discussed this after the meeting. He confirmed that the ones I had identified as unofficial leaders were exactly that. He called them natural leaders. He explained to me that those are the types of people that he takes care to develop and encourage to advance their careers.
We also attended a meeting with the nurse educator for the 4th floor. They are developing a charge nurse workshop for new and existing charge nurses on the unit. They discussed many topics to be incorporated into the workshop, including managing up, dealing with frustrated families, and dealing with difficult physicians. It was good to see how these types of education are developed. I have been to many of them, but have never been involved in the development.
We also attended a meeting with the nurse educator for the 4th floor. They are developing a charge nurse workshop for new and existing charge nurses on the unit. They discussed many topics to be incorporated into the workshop, including managing up, dealing with frustrated families, and dealing with difficult physicians. It was good to see how these types of education are developed. I have been to many of them, but have never been involved in the development.
Sunday, November 1, 2009
Mid Semester Evaluation
o 2 Course Clinical Objectives and 2 Personal Objectives so far in the course; relate your progress on these objectives to your work in your specific clinical site.
I have met some of the clinical objectives. Two of the main clinical objectives that I have met are Critical thinking and Cultural competence. For critical thinking, I frequently ask O.C. questions. I analyze both sides of a topic (nursing unions) before making a judgement. And I can logically defend my opinions and decisions. For cultural competence, I have discussed culture and race in depth with my preceptor. He is a minority, as are many of his nurse managers. We have discussed the makeup of nursing at Cook Children's and if it is becoming more diverse or not. I feel a lot more culturally competent after these discussions.
I have also met some of my personal objectives. I have identified steps in the conflict process and how to deal with conflict in the workplace. I have witnessed my preceptor navigate his way through conflict on one of his floors. It was very enlightening. I also have applied time management skills in planning clinical experiences. My clinicals have been difficult to accomplish at times. But, I have managed to balance that with my full time job and my home life.
o An overall review of your personal objectives and reflection on how you have/have not accomplished them, support either with reasons and/or examples;
I discussed two of my personal objectives in the previous question. I have identified steps in the conflict process and how to deal with conflict in the workplace. I have witnessed my preceptor navigate his way through conflict on one of his floors. It was very enlightening. I also have applied time management skills in planning clinical experiences. My clinicals have been difficult to accomplish at times. But, I have managed to balance that with my full time job and my home life.
The other two are using leadership principles in making policies for staff and researching types of budgeting and indentifying the type used at my clinical site. I have discussed the budget with my preceptor, but I still need to research what kind of budgeting that he uses. We have yet to discuss making policies for staff. I will try to focus on these in future clinicals.
o Statement and discussion of one way these items have fostered your growth as a professional nurse.
All of these things have fostered my growth as a professional nurse. As I have mentioned before, I am new in a management role in my job. I have been able to take some of the things that I have learned and apply them almost immediately to my professional position. I have especially used critical thinking and conflict management. I have applied the conflict resolution process used by my preceptor in my own job. I have also been making an effort to analyze all situations from all sides and making an informed decision. I have learned a lot!
I have met some of the clinical objectives. Two of the main clinical objectives that I have met are Critical thinking and Cultural competence. For critical thinking, I frequently ask O.C. questions. I analyze both sides of a topic (nursing unions) before making a judgement. And I can logically defend my opinions and decisions. For cultural competence, I have discussed culture and race in depth with my preceptor. He is a minority, as are many of his nurse managers. We have discussed the makeup of nursing at Cook Children's and if it is becoming more diverse or not. I feel a lot more culturally competent after these discussions.
I have also met some of my personal objectives. I have identified steps in the conflict process and how to deal with conflict in the workplace. I have witnessed my preceptor navigate his way through conflict on one of his floors. It was very enlightening. I also have applied time management skills in planning clinical experiences. My clinicals have been difficult to accomplish at times. But, I have managed to balance that with my full time job and my home life.
o An overall review of your personal objectives and reflection on how you have/have not accomplished them, support either with reasons and/or examples;
I discussed two of my personal objectives in the previous question. I have identified steps in the conflict process and how to deal with conflict in the workplace. I have witnessed my preceptor navigate his way through conflict on one of his floors. It was very enlightening. I also have applied time management skills in planning clinical experiences. My clinicals have been difficult to accomplish at times. But, I have managed to balance that with my full time job and my home life.
The other two are using leadership principles in making policies for staff and researching types of budgeting and indentifying the type used at my clinical site. I have discussed the budget with my preceptor, but I still need to research what kind of budgeting that he uses. We have yet to discuss making policies for staff. I will try to focus on these in future clinicals.
o Statement and discussion of one way these items have fostered your growth as a professional nurse.
All of these things have fostered my growth as a professional nurse. As I have mentioned before, I am new in a management role in my job. I have been able to take some of the things that I have learned and apply them almost immediately to my professional position. I have especially used critical thinking and conflict management. I have applied the conflict resolution process used by my preceptor in my own job. I have also been making an effort to analyze all situations from all sides and making an informed decision. I have learned a lot!
Clinicals Week 7
The week of October 26th, I spent a total of 4.5 hours with my preceptor. One day we discussed my change project (a quick reference for the nurses to use for a complicated test that they do on this floor). O.C. told me about the feedback that he had gotten so far. It sounded like the nurses liked it. I plan to give them a survey after it has been in use a little bit longer.
We also attended a Quality Improvement Council meeting. This council regulates quality for the whole hospital. They also track quality indicators. At this meeting there were also two pesentations regarding research at Cook Children's. One of the presentations was a research project that a nurse had thought of for her master's program and then actually implemeted it at work. She implemented a line insertion team in the NICU. This team now inserts over 90% of all PICC lines in the NICU. This team also rounds on each of these lines daily and teaches staff about caring for the lines. In the first year, they have decreased infections from central lines by over 80%. She showed a dramatic improvement with graphs. She stated that the hardest part to implementing this project was getting physicians and administration to buy into it. I can believe that! But, it was amazing data nonetheless. I was astounded at the results! I would assume that this would produce some hospital wide changes and maybe even further reaching than that. She is presenting at quite a few conferences.
We also attended a Quality Improvement Council meeting. This council regulates quality for the whole hospital. They also track quality indicators. At this meeting there were also two pesentations regarding research at Cook Children's. One of the presentations was a research project that a nurse had thought of for her master's program and then actually implemeted it at work. She implemented a line insertion team in the NICU. This team now inserts over 90% of all PICC lines in the NICU. This team also rounds on each of these lines daily and teaches staff about caring for the lines. In the first year, they have decreased infections from central lines by over 80%. She showed a dramatic improvement with graphs. She stated that the hardest part to implementing this project was getting physicians and administration to buy into it. I can believe that! But, it was amazing data nonetheless. I was astounded at the results! I would assume that this would produce some hospital wide changes and maybe even further reaching than that. She is presenting at quite a few conferences.
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