REFLECTIVE JOURNAL- WEEK 16

As I look back on this semester, I have learned a number of lessons regarding leadership in nursing. Leadership is not something that comes easily- you must form positive connections with those you are leading and show them what their full potential can look like by being a good example yourself. There are many attributes that comprise an excellent leader. Throughout our discussions and assignments in this class, we explored concepts and theories of leadership as well as management and power as a foundation for nursing organizations. People will follow a competent person who has the knowledge needed in order to complete the mission successfully. Leaders ensure that individuals know their purpose and encourage and help them to achieve that purpose. In order to have a successful organization in healthcare, you need to assess needs and implement change effectively as this environment is always changing. Evaluating effectiveness of cost and quality of care with consideration of budgetary constraints was hard for me to understand because I haven’t studied much about the accounting behind budgeting to this degree. I find it hilarious that I heard recently at my hospital that those at the top of the company were complaining about how much they had to pay nurses in overtime, WHEN THEY REQUIRE AND MAKE US WORK OVERTIME THAT WE DON’T WANT TO WORK IN THE FIRST PLACE.

We also learned that analyzing policies and procedures used in management of a nursing unit is important because it helps in providing optimum care. In the operating room, we have policies that are in place to keep patients safe- this includes triple checking medications and specimens sent to the lab or pathology. Principles of risk management and assisting employees with special needs is important because in the healthcare field it’s easy to get hurt if you are not careful. I said before, I work in the OR and there are many risks involved in surgery. Pre-operative time-outs are one way to decrease this risk significantly and prevent wrong-site surgeries.

Identify leadership and management competencies which contribute to optimal organization climate and culture. Some of these include: Questions and challenges the status-quo on diversity. Takes innovative approaches to build, support and maintain a diverse workforce. Communicates team objectives and accomplishments both inside and outside the team. Ensures cross-team collaboration for organizational effectiveness. Builds rapport and ensures others are informed. Works to resolve obstacles outside of the team’s direct influence. Shares resources to solve mutual problems. Models behaviors that maximize group participation by consulting, listening and communicating clearly. Builds team cohesiveness. Actively builds relationships with team.
My individual nurse philosophy related to leadership and management is to show empathy and support to every single individual. I want to be the kind of leader that inspires and encourages others through honesty, good communication and GRIT. Grit means hard-work- working alongside the team and being at their level. Even if you have good ideas and want to implement change, you cannot do this without having a positive relationship with those you are leading. This is my very last semseter at Utah Valley University and I am beyond grateful for the education, excellent teachers who became my role models, and oppertunities I was given throughout these last 7 years. I accomplished my dreams of becoming a Registered Nurse! Finishing my Bachelors in Nursing has always been a goal of mine as well, and I am so excited for what the future holds. 

“No matter how well you apply the art of leadership, no matter how strong your unit or how high the moral of your men, if your leadership is not directed completely toward the mission, your leadership has failed.” -Curtis E. LaMay

REFLECTIVE JOURNAL- WEEK 15

RISK MANAGEMENT 

Throughout this week we discussed risk management and the role that nurse leaders have in this process. Ensuring that the strategic goals of the organization align with patient safety is essential. There are many aspects to risk management and it requires coordination of process changes, data collection, data analysis and evaluation.

It is important to coordinate with other healthcare providers/managers to establish a structure that provides safety of care through quality care. Assessing specific needs and then taking action will help to decrease risks and impact patients and staff for the better. I work in the operating room, and we have SAFETY SHARING every single day before we start our shift. We constantly address risk management and ways to keep our goal of Zero Harm. Zero harm refers to an approach to occupational safety that has been adopted by many workplaces. The goal of a zero-harm approach is to operate a workplace without exposing an individual to injury through the implementation of safe work systems. Zero-harm approaches are linked to exceeding safety regulations. You would think that eventually we would run out of things to discuss in our safety sharing meeting, but there is ALWAYS something new or something repeated that needs to be addressed.

As nurses we are patient’s advocates when they are most vulnerable. This is especially true in the operating room when patients are under anesthesia. An important aspect of risk management in the OR is pre-operative timeouts. We address fire risks, sharp safety, identify the patient and specific type of surgery that is to be performed, etc. We are 100% accountable to ourselves, 100% accountable to our coworkers, and 100% accountable to our patients. We each need to do our part to ensure ZERO HARM. This takes critical thinking and awareness of what is going on around us in these ever changing environments of healthcare. 

 

 

 

 

 

 

REFLECTIVE JOURNAL- WEEK 14

MOTIVATION-

This is something that seems to be nearly impossible to consistently have in our lives. In healthcare, it’s essential to create environments that fuel motivation of employees so that they can perform to the best of their abilities. This week we looked into ways in which we can motivate staff and increase productivity. “Unfortunately, motivating people is far from an exact science. There’s no secret formula, no set calculation, no work sheet to fill out. In fact, motivation can be as individual as the employees who work for you. One employee may be motivated only by money. Another may appreciate personal recognition for a job well done. Still another may work harder if she has equity in the business.” As you can see, motivation completely depends on the individual. That’s why it’s essential to encourage and allow employees to voice their opinion and express what changes can be made to help them work to their best potential. As a group, we composed a list of ways or things that could help increase morale in a hospital setting. Some ideas we had included the following:

-Take a genuine interest in their work-life balance – To the extent that managers can offer some flexibility in schedules and be understanding about family commitments. This would be greatly appreciated. Small gestures often make a big difference!

-Provide sufficient paid time-off. Everyone needs to take a vacation every once in awhile. This honestly helps with well-being and increases work performance in my opinion.

-Provide many opportunity for advancement. People want chances for training and cross-training. If these opportunities are available to employees they would be more likely to stay.

-ENCOURAGE and spread positivity! It all starts with attitude- if people are genuinely happy and interact with others in a positive way it makes work much more enjoyable. 

-Ensure that you are not short-staffed. Stress can be created by an environment that is chaotic. If there are enough staff so that each person doesn’t have to run themselves thin, this will help create a less stressful environment.

I think it is ESSENTIAL that we first create a safe, positive, encouraging environment if we want to motivate employees. By communicating effectively and listening intently, we will begin to understand each individual’s needs and ways that they themselves are motivated. I hope that I will be able to use this week’s lesson in my personal life as well as my work life. I have always found it to be hard to keep myself motivated for long periods of time. Especially with working out and eating healthy. I use excuses such as “I’m too busy! I don’t have time today! I’ll do it tomorrow!” which doesn’t get me ANYWHERE. I love that we studied this topic, and will I strive to be POSITIVE, WRITE DOWN GOALS, and MOTIVATE MYSELF. 

REFLECTIVE JOURNAL WEEK 13

COMMUNICATION

This week we learned and discussed different types of communication. Communication is the key that opens the door to success. In healthcare, effective communication is essential for providing quality care to patients. As nurses, we are the “middle man” between doctors, patients, patient’s families, and a number of other healthcare providers. We are often the strongest link that keeps the chain strong. We learned about the differences between aggressive and assertive communication. I have seen examples of both of these types of communication in my career so far. Conflict cannot be resolved if people are communicating in a violent or aggressive way. It creates more destructive disagreements and disputes. We need to remember that empathy is the best policy. It doesn’t matter if the other party is at fault- we still need to respect others and try to understand where they are coming from. 

REFLECTIVE JOURNAL 11

We learned more about a subject I don’t have a lot of practice in this week- and that is the topic of STRATEGIC PLANNING IN HEALTHCARE. In our reading for this week, I read an interesting article that states, “Creating a strategic plan gives everyone in your organization a working roadmap for the future. The pieces of the plan help guide daily actions—everything ranging from how to allocate company resources, to how to engage stakeholders. Even small companies need a strategic plan to formalize their values and vision, which guides goal setting while also allowing them to measure their impact beyond the bottom line.
Most strategic plans define the organization’s Mission, Vision, and Goals, and establish short-and long-term Objectives. Creating the plan might seem daunting, but referring to the plan keeps team members connected to guiding principles and actually makes daily operations easier.” This made me think about the fact that we need to create a mission and vision for ourselves in our personal lives. If we do not have a roadmap for success then we will become lost. What is our purpose? We need to figure that out and then plan accordingly. In nursing, we need to align our short and long-term objectives with our goals and really focus on moving in a positive direction. 

REFLECTIVE JOURNAL WEEK 10

This week we discussed change and how this effects nurses and how to be a positive role model to others. It was interesting to watch the video “Who Moved My Cheese” about change and then discuss with our teams how we felt we reacted to change. I feel like I am apprehensive to change (when it makes me uncomfortable) and do have fears, but I face them and try to have a positive attitude as I walk through the “fire” so to speak. I think ways that a nurse leader can handle resistance to planned change is by being very open with communication and listening to and asking for people to voice their opinion. By having a positive attitude and being a good role model by implementing the change yourself, you can affect others attempt to change. I chose an article about diversity and being aware of equality in the workplace. There was an incident that happened at my work where a charge nurse ended up losing his position because he made a racial comment that ended up turning into a fight. It made me realize that it’s very important that we watch how we talk to others and treat people with respect.

 

 

Budget Interview

  1. What is the most common budget constraint you frequently run into and how can it be fixed?

The most common budget constraint is restrictions on how many people you can hire. How can it be fixed? Have infinite money of course! (haha I wish). No but in all seriousness, you can make a proposal about hiring someone and explain why it will help to accomplish projects that need to get done. For example, at one point, I knew that we were going to need more software testers to get this big project done. It took a lot of work and convincing to get more testers hired. You have to anticipate, plan, propose, and then convince those who are above you for approval. It’s hard work.. you have to prove and help others understand why the budget restraint is hurting the company.

What is your favorite thing about budgeting at your company? What I like about budgeting is that I am able to help the company improve by budgeting efficiently. 

What is your least favorite thing about budgeting? One thing I don’t like about budgeting, is that it’s usually only reviewed annually, and therefore budget planning gets misaligned with actual priorities. If there are changes in the middle of the year it usually is hard to fix right away.

What do you find to be the most difficult about planning your budget? What I find most difficult is that it’s really hard to know and anticipate the needs and resources we will have to have to complete projects. You usually don’t exactly know until you start the project (and then the budget might be too low or too high).

How does budgeting affect your employees & customers? Budgeting affects employees because it allows you to hire people, and it affects the whole team if you don’t hire the right people or enough people. In some cases, it might mean letting some employees go, which could affect the company (for worse or for better). Budgeting affects costumers indirectly because it can change the quality of service they receive.

What is the main cause for being over budget? The main cause of being over budget is probably underestimation.. For example, if you underestimate how much a project will cost and then it ends up taking 6 more months to finish, this means the company will have to spend money they didn’t anticipate using. This is often how companies end up going over budget. 

What is the main cause for being under budget? The main cause for being under budget would be employees quitting. Another common reason would be deciding not to hire more people.

Who helps oversee the budget for the company? The boss or manager of the company, along with other financial advisors and other employees who know what resources the company needs.

How often do you make changes to your budget? In my company, we make the biggest changes annually. However, if there is a need for a change in the budget throughout the year then we will look at it more often and implement 

How often do you fire employees as a way of decreasing your budget? In my company we honestly don’t fire employees to decrease the budget that often. We need employees to keep up with our work load!

 

This interview was interesting because I learned that budgeting really takes a lot more effort than I expected it would. You have to learn to anticipate needs of the company so that the whole team will benefit. This takes practice and skill of paying close attention to detail! In my own personal life, I need to take time to go over my budget so that I can save more money. I also agree with the person I interviewed that having infinite money would solve all budgeting needs ;). 

Reflective Journal

This week we had two discussions that brought up some interesting topics. The first discussion was about staffing in the workplace and how it affects patient care. In the Operating room where I work, it seems like we are always short-staffed. The reasoning behind this is that it takes more than half a year to train someone in the OR. Because it takes so long to train, if we have multiple nurses or scrub techs quit all at once we are short-handed until people come off orientation. We actually had a conversation in our meeting the other day, where the OR management said our budget was already tight so we needed to be careful about the number of FTE. It’s crazy to me that the hospital doesn’t see our needs to accommodate the increase in OR suites that came with the new building. You would think that patient safety would be their first concern but it seems like money takes priority in their eyes. We also discussed our five-year plans as nurses and how we were going to accomplish our goals. It was good for me to actually write-out my plans for the future because I need to start working towards my next steps in life. In one of the assignments for this week, I read an article about dangers in the workplace such as hazardous fumes. Working in the OR there are risks for accidents by (lifting heavy patients, radiation, needle-sticks, getting hit by a patient waking up, fumes, etc.) We need to be more aware of the risks for each of our specific jobs. The future of my nursing career is in my own hands! I have realized that I need to prioritize my time in working towards my goals that I have set for myself. “SUCCESS IS NEVER OWNED, IT’S RENTED. AND THE RENT IS DUE EVERYDAY”

REFLECTIVE JOURNAL- WEEK 8

This week we learned more about the future of nursing, based on the Institution of Medicine. It was interesting to read the articles for this lesson and learn what is significant moving foreword in the field of nursing. “The campaign is working to improve our collaborative work with the physicians, consumers and others who understand that nursing practice and care will only be enhanced if all providers are allowed to practice to the top of their education and training. And, in fact, we do have physician champions, who are extremely supportive of our work around modernizing scope of practice laws, but won’t speak out publicly.” The IOM also stated they were working on achieving a goal of having nurses receive their bachelors degree and even better, go on to obtain a higher education. The hospital where I work at assists in paying for nurses to receive their bachelors degree as incentive which I think is smart. The higher the level of education, the more competent the nurse will be in their job. I think it’s important that we utilize hands-on practice and collaboration with physicians and other healthcare providers while in nursing school to more prepared for real-life scenarios. Throughout this week, I have began to understand more the importance of my voice in changing policies related to nursing and I have a goal to become more involved. 

Reflective Journal- WEEK 7

1. What did you actually learned from the unit. This week, we talked a lot about budgeting and the basic concepts of being cost effective while providing quality care and patient safety. It was interesting to listen to the lecture videos and watch the breakdown of how nurses get paid for their services. You have to determine if the services the nurse is providing is minimal, moderate, or extensive (and that determines their pay). Everything has a cost- and you can control expenses. You have to look closely at your staffing (the experience determines wages and you can control that). We also discussed time management. In the OR where I currently work, timing is everything. We try to go as fast as we can without compromising patient care. Sometimes this can lead to problems– for example, sometimes surgeons don’t initiate time-outs because they want to hurry. This is an essential part in preventing wrong-site surgeries so it’s frustrating when surgeons don’t take it seriously. Along with time-management, it’s also essential to learn how to appropriately delegate. I feel as if I’ve learned this skill as I am the middle man between SO many different groups of healthcare providers in the Operating Room. As I delegate efficiently, my cases go a lot smoother. As a group, we looked over a spreadsheet of expenses from a unit at the hospital. We had to figure out how to cut 10% from the current budget. This was a good team building experience and we were going back and forth whether we should cut more from the supplies or the nurses wages. I actually learned a good deal from this lecture just because I am not so good with budgeting yet. I will be able to ability to analyze costs and budgeting not only in my life at work but also my personal life. We also interviewed a person outside of healthcare regarding discipling and firing employees. I discovered that I don’t really want to be in the position of firing people.. haha. Mostly because I am such a people person and I absolutely hate making people feel bad. I give people countless chances, even when they let me down. 

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