Nurse Administrator Practicum - Lori Majeske Portfolio



Nurse Administrator PracticumLori A. MajeskeFerris StateAbstractThe role of nurse administrator is complex. Learning to employ many techniques to engage and encourage team members is essential. Using the ANA Nursing Scope and Standards of Practice for Nurse Administrators and AORN Standards and Recommended Practices for Inpatient and Ambulatory Settings, along with theory and evidence-based research; an exploration of the concept of nurse administrator as a leader, mentor, coach and communicator is discussed. A project exploring a surgical fire with evacuation will be described. Strategies to address issues and concerns are developed. Analysis of the information is included to determine goals and objectives criteria. Keywords: transformational leader, engagement, emergency preparedness and communicationNurse Administrator PracticumThe nurse administrator may work in a variety of settings. The role of an administrator uses leadership skills and multiple resources to guide personnel. The use of the American Nurses Association (ANA) Scope and Standards of Practice for Nursing Administration provides statements to guide this role (American Nurses Association [ANA], 2010). Nurse administrators must use creativity and innovation to engage personnel. Combining these skills with business acumen and an understanding of regulatory guidelines will assist the nurse administrator to provide leadership in any setting. The nurse administrator faces many challenges in this role. The continuing development of evidence-based practice, changing regulations as well as the current economic situations faced, need to be monitored and analyzed for appropriate actions. This paper will explore the issues, challenges and concerns faced in one setting while analyzing the strategies used to address these concerns. Theory, research and an application of knowledge will demonstrate the ability to adapt to the changing environment of a nurse administrator. A clinical project describes the need for continuing education and communication with multiple resources within the hospital and the community. The practicum is evaluated by both the preceptor and student according the goals and objectives proposed. Practicum The role of nurse administrator may be developed in a variety of settings and encompasses many levels of leadership. These may range from leading a small team within a small hospital setting to senior leadership roles including Chief Nursing Officer. In order to understand the scope of this role, the nurse administrator can use the Nursing Administration Scope and Standards of Practice to provide structure to the role. This will assist in the advocacy for nursing while creating an atmosphere of understanding to provide quality services using evidence to guide practice (American Nurses Association, 2010). Using transformational leadership to implement an organizational structure will be required to sustain healthy outcomes in a pay for performance (PFP) environment (Everett & Sitterding, 2011). This environment may include multi-disciplinary teams caring for patients with much higher levels of acuity in a shorter period of time. In order to sustain healthy outcomes, leaders must provide a vision using innovation and communication. This is not a new idea, but should be considered when developing long-term plans. Accountability of members will be critical to support change initiatives (Aroh, Occhiuzzo, & Douglas, 2011). As I explored my role as a nurse administrator student, I found communication to be one of the greatest challenges. Determining the most effective method of communication was the most critical element. The dynamic structure of the environment produces challenges to ensure members understand what changes are taking place and must provide an opportunity to ask questions, seeking clarification of information. Using this as a base for proposed goals, I developed a plan to use communication throughout my experiences to enhance my skill level and provide leadership. I developed a plan to research and provide an educational experience for personnel using critical thinking and communication to provide care to patients in an emergency situation. I furthered developed a plan to use the Scope and Standards of Practice for Nurse Administrators to enhance my role as a leader within my departments and within the hospital setting. The use of open communication techniques to explore my strengths and weaknesses as a nurse administrator student will be an element throughout this experience. The use of appreciative inquiry and mentoring to promote change, while employing emotional intelligence and transformational leadership to guide this work is demonstrated.Appreciative inquiryThe American Nurses Association (ANA) scope and standards of practice describe a philosophy and methodology to promote positive work environments (American Nurses Association, 2010). To foster open communication and conflict resolution, I need to consistently look for opportunities that allow teams to explore methods to express ideas. Engaging them in conflict resolution with each other can be time consuming at the forefront, but can lead to creating a culture where they will hold each other accountable for their actions. According to Cooperrider and Srivasta, the developers of theory of appreciative inquiry, the moment of change begins at inquiry (The Center for Appreciative Inquiry website, n.d.). They further explain that people are receptive to sharing positive things of them. Throughout my practicum, the use of appreciative inquiry was employed. As I explored the many reasons for frustration and perceived lack of commitment, noted in an employee engagement survey, I used this as a framework to conduct meetings. The open dialogue with staff in small focus groups, allowed me to ask questions and encourage staff to clarify any uncertain comments or suggestions. I find this an effective method of teaching and communication as it allows me to gain a better understanding of where any areas of discrepancy may have stemmed from. This can be used as I continue my daily routine as I can look for trends in lack of communication or processes that cause errors or potential errors. MentoringThe American Nurses Association Scope and Standards of Practice for Nurse Administrators also use the framework of practice to include mentoring as an essential element of performance (ANA, 2010). A mentor is defined as a trusted counselor or guide by Merriam-Webster (2012). Mentoring is useful for both parties often creating winning situations for all. These can include sharpened skills, expanded networks and increased confidence (Heathfield, 2012). Using this theory to promote successful relationships within my peer group and teams, I can fully appreciate the need to both be a mentor and have a mentor. My new role as a manager allows me to assist in the development of direct reports. On the other hand, I am new to my role and need guidance and a person to bounce ideas off of as I promote growth and change. During this practicum, I used information provided during a course offered through McLaren Leadership Academy for managers whose departments received low scores on an employee engagement survey. This course “Change Anything” offered leaders methods to “become a scientist” to explore reasons change does not occur (Patterson, Grenny, Maxfield, MacMillan, & Switzler, 2011). This is a helpful tool to provide structure to determine why something is problematic. The problem can occur for a multitude of reasons and each person may have a different motivator to resolve the issue. This inquiry can be used to provide feedback when attempting to create change. Emotional intelligence can be integrated into the mentoring role to assist in controlling negative emotions while working with individuals, thus creating positive work environments.Emotional intelligenceEmotional intelligence conveys a need for honesty and flexibility for nurse administrators. ANA suggests proactively responding to trends to promote change (2010). This basis allows a person to influence people and remain optimistic when adverse situations arise (Kiracofe, 2010). The article further suggests using this concept when hiring and training individuals to create a positive workforce. This can equate to a healthy financial outcome as employees are more productive and have higher rates of retention.There are empirical studies by Quoibbach and Hansenne that show positive correlation between emotional intelligence and group cohesiveness (Suliman, 2010). There may be a relationship between emotional intelligence and coping mechanisms. I need to consider these variables when making change. Groups will tend to be cohesive when the change is not viewed as a positive one. I feel this happens more often when staff does not understand why the change is necessary. I must also remember to include the “whys” of situations and not just use dictatorial methods to produce results. This is sometimes difficult for me to do, especially when I know the change will produce this mixed result. Necessity is important and sometimes just knowing why the decision is made is enough to soothe the emotional aspect associated with change. If change will take place or decisions need to be made, I attempt to promote a shared governance model allowing staff to make decisions regarding some aspects of change. This model of shared accountability can assist staff with a participative style of management which may be beneficial for both parties ("Shared Governance," n.d.). Emotional intelligence can assist the nurse administrator student when attempting to make change. The need for honesty and open communication will promote transformation, sharing responsibilities between leaders and followers. This function of practice for nurse administrators will use communication and constructive criticism to create the desired change necessary to ensure healthy outcomes.Transformational leadershipTransformational leadership proposes additional ways to use open communication techniques to create commitment by employing greater meaning and shared responsibility between leaders and workers (ANA, 2010). Research suggests two competencies for nurse leaders to employ to create a transformational leadership exemplar. These competencies, creating structures to ensure access to information, resources and support, and creating expectations for innovative, dynamic, empowering, and accountable behaviors of leaders and nurses can assist leaders in this journey (Everett & Sitterding, 2011, p. 401). Evidence-based practice will be an important tool as healthcare workers work toward value based purchasing. According to Tomlinson, transformational leadership works when teams have clear priorities and a clear vision of the organizational goals (2012). Additional studies suggest that participants will be more productive and provide satisfactory care to patients when working with leaders that employ transformational leadership styles (Brown, 2010).One leadership theory uses transformational leadership behaviors. This theory, full-range leadership theory, is based on Burns ideas of leadership claiming a high degree of credibility with followers (Kanste, Kaarianen, & Kyngas, 2008). There were daily opportunities to enlist this theory throughout this nursing administration practicum. The project for this practicum provided another opportunity to work together to promote needed change using many of the above described concepts and theories. Theory can assist new nurse administrators with clear elements to build a framework of practice. This is exemplified in the ANA framework for practice described above. This framework allowed me to demonstrate competency in the standards of planning, collaboration, and resource utilization for this practicum. PlanningThis practicum provided me with an opportunity to strengthen my ability to appropriately plan to achieve specific goals. The ANA Standards of Practice include measurement criteria for this standard (American Nurses Association, 2010). Identifying issues, problems or trends and utilizing the plan to provide direction to team members are two criteria demonstrated during this practicum. Examples of planning include preparing for meetings with the Surgical Services Department as well as the Surgery First Wednesday meetings with surgery staff. These meetings are used to provide information to attendees to communicate important information as it relates to trends in volume, needed improvements within the environment and any economic trends that may result from these deficiencies. Gathering data from various sources, verifying the accuracy and analyzing trends is one of the functions of the nurse manager role for surgery. Developing action plans to increase efficiencies from both a human resources perspective and a budgetary perspective is a challenge. Communicating this information is vital to the various department groups. I also developed a plan to provide an educational opportunity as part of this practicum. This included a fire drill and involved several hospital departments as well as community services. The need to create change and transform the mindset of surgery team members was challenging for this project. We currently did not consider the need to assess the fire risk of each patient and have not planned or participated in any type of fire drill that would include an evacuation plan. This situation involved a multidisciplinary group to provide support and to educate those involved. Not only did the surgical staff need to develop a plan, the Bay City Fire Department had not had any recent walk through in the area. This could cause a delay in response time if the appropriate information was not relayed during an actual emergency. Using research, evidence-based literature, current guidelines and facility policies, the project was scheduled and will be discussed in detail. Collaboration The collaborative effort of nurse leaders is an essential part of practice. Collaboration with all levels of nursing and other key stakeholders to enhance patient care and provide satisfactory outcomes is the intended goal. Goal achievement will not be obtained if all members do not agree with the stated objectives. This was evident in one of the various groups I had the opportunity to work with. The development of a hybrid OR room brought a multi-disciplinary team together to achieve of the goal of increased market share for vascular procedures. This new technology involves the surgical and cardiac and interventional radiology teams to provide care to patients through a minimally invasive approach. In order to promote a healthy environment where the exchange of ideas and support of the goal was the main focus, each member had to be willing to listen to suggestions from other members. Carr describes five competencies necessary for collaborative leadership; delivering patient-centered care, working as part of an interdisciplinary team, practicing evidence-based medicine, focusing on quality improvement and using information technology (Carr, 2009, p. 178-179). I also had the opportunity to work with other individuals whose goals were not in line with the project. This created a longer working time and diminished the importance of those members’ contributions, in my opinion. A challenging first few meetings brought about the need to create agenda and guidelines. I had the opportunity to attend this meeting with my preceptor, Willa Rousseau, RN, MSN as well as my director Linda Szafranski, RN, MSN. Working with the two of them, and being able to share ideas and have a sense of being an essential part of the team, inspired me to use this as a model throughout this practicum. This collaborative effort also allowed me a better understanding of resource utilization. Resource utilizationThe use of resources in any environment, whether the resource is part of the workforce, or is considered in the outlay of the capital budget, is a prominent part of the nurse administrator role. Demonstrating competence in this standard was evident throughout this practicum. As previously mentioned, a collaborative effort between two procedural areas will provide care to a new population of patients. These patients will more than likely have higher co-morbidities and will need to be evaluated for high risk situations. The nurse administrator will need to develop evaluation methods to ensure safe, effective care is being delivered. Organizational fiscal responsibilities were developed during this practicum. The need to consider a reduction in the workforce, either through attrition or through layoffs was requested. This challenge provided me the opportunity to examine all roles within the area of responsibility. Further examination allowed to me to use open dialogue with leadership members to determine final plans. This open dialogue was necessary to promote the change necessary to maintain a fiscally responsible outcome. To assist in the development of this plan, several meetings took place under the direction of Greg Purtell, Vice President of Human Resources. Mr. Purtell is also attempting to create change within the organization and held meetings to discuss new initiatives involving staff performance measures. These tools will assist administrators to more effectively evaluate employees and guide behaviors to increase promotion of the use of disciplinary action in the event dialogue and education are not enough to create change. These competencies are an important element to the success of the practicum, but one cannot underestimate the need for constant, open communication in all aspects of performance. This is evident as I developed my project of fire risk assessment including a simulated fire drill and evacuation of a surgical suite. This project is necessary due to a recent incident in the department of surgery. The idea for this project came as a result of listening to a Keystone Surgery conference call where cohort members are encouraged to participate and share experiences to enhance the practices of other cohorts. With this in mind, I developed the project using literature, facility policies and evidence to provide an educational experience allowing members to explore scenarios and review appropriate materials to provide care for a patient in an emergency situation specific to our facility. ProjectAs part of the practicum, a project was assigned. I chose to create a plan addressing the need for a fire risk assessment for each surgical procedure as well as developing a plan to evacuate the department in the event a fire cannot be controlled. Due to the many renovations within the department and additional rooms added, the evacuation routes were unclear. To further compound this issue, the regulations are different depending on the year when the area was constructed. We have had fire drills previously, but have not attempted to evacuate a room. Research shows between 550-650 fires occur each year ("Preventing Surgical Fires," 2011). These fires can range from a small flash fire, to complete burning of drapes and linens. The most effective way to fight fires is prevention. There are three sources needed to create a fire, ignition sources, fuel sources and an oxidizer. The need to actively discuss each patient’s risk assessment is essential. The Anesthesia Patient Safety Foundation (APSF) has created an algorithm for use in a procedural setting. A copy of this algorithm is provided, see Appendix A. Each member of the surgical team, surgeon, anesthesia provider and nursing staff including the scrub person and circulator need to clarify any potential source of fire in each procedure, A good understanding of the process is essential. There are other critical factors related to fire prevention. These include proper prep used for procedure, securing airways on patients having procedures above the level of T5, allowing the prep to dry without pooling of fluid specifically at the bedside, and tenting the drapes around facial procedures to decrease the incidence of vapors to build up. Ignition sources including bovies need to be controlled in a holster when not in use. Using the lowest possible concentration of oxygen is also important. Other useful tips are described in the AORN Perioperative Standards and Recommended Practices Safe Environment of Care, Recommendation IX (Association of PeriOperative Nurses, 2012). To prepare for this project, many hours were spent researching information from regulatory and governing bodies, as well as internal hospital policies and procedures. It seems the more I researched, the more I found, the less confident I felt to adequately teach the group. Given that frame of mind, I thought it may be a good idea to enlist the teaching of Benner exploring novice to expert. Benner describes five levels of nursing experience, novice, advanced beginner, competent, proficient and expert (Benner, Tanner, & Chesla, 1996). I feel I am at an advanced beginner stage with the project as a whole with certain areas having a higher degree of proficiency than others. I feel it is important to use this theoretical framework as a guide and discuss with staff, expressing my desire to learn alongside them and understanding the complexities of the various situations. I further explained we would need to use this presentation as a starting point and gain knowledge as a group, relating experiences and learning best practices. Additionally, this project also required an evacuation plan. This was of great interest to me after hearing about another facility experiences at a recent webinar. The presenter explained she spent six months preparing for this event. I was not allowed that amount of time, given the constraints of this course, but knew we would be continuing this journey. I began a search of department policies to determine a starting point for procedural engagement. We had one vague policy related to emergency preparedness so I needed to extend my search to include the facilities and maintenance departments as well as security since they are resources for any fire within the facility or campus. This garnered more information and is used as reference along with information from AORN, American Society of Anesthesiologists (ASA), the Food and Drug Administration (FDA) and the ECRI Institute. The ECRI Institute is “an independent nonprofit organization researching best approaches to improving the safety, quality, and cost-effectiveness of patient care (ECRI Institute, nod, p. 1).” McLaren Bay policies were reviewed and pertinent information prepared for use at committee meetings and as resources for PowerPoint presentation. A multidisciplinary team is assembled. This includes security, environmental services, facilities and maintenance, nursing, anesthesia providers, surgeons and the fire department. We met at times most convenient for the fire department since all other members worked at the hospital. The fire department representatives were not familiar with the physical layout of our department. According to McLaren Bay Region safety policy 60, each member of the response team has specific duties (Warszawski, 2012). These include a member of environmental services and facilities greeting the Fire Department at a designated location. Since we have two main entrances serving different areas of the hospital, we needed to ensure a standard location was identified; also adding to the complexity is the hours of operation of our department. A member of the surgical team will meet the group at the designated location when staffing allows, but during off shift hours, we will not. A copy of the floor plan will be stored in both designated greeting points for the surgical department. Appendix B shows a copy of the floor plan for both the main and south towers. The four colored areas represent the four air handlers used in surgery. If a fire trips the smoke detectors, the air handler will shut off. If the procedure needs to be evacuated to another room, you must make the best determination based on sufficient air handlers. Each air handler services more than one room. This was part of the plan for my presentation. Each room will have a laminated copy of routes A and B to take with them if they need to evacuate. The determination of routes to use and relocation will be decided by the management team member serving as incident commander and running the daily surgery schedule. Much good discussion ensued at these meetings with the main point of understanding the routes available for evacuation and the need for continued infection prevention standards in the event of such a crisis. It should also be noted within a week of presentation, I was told my time would be cut from two hours, to just over one hour. I needed to make considerable cuts to the presentation without losing valuable information. It is not uncommon to have plans change at this facility. As a leader I understand the dynamic nature of our role and encourage staff to be empathetic to these circumstances.Overall I feel the project was a positive learning experience for our group and me individually as the person educating herself on this very important topic. The complexities of the environment create more intricate puzzles on a daily basis. This demands the need for structured plans and processes in order demonstrate an effective emergency plan. The policies associated with this plan need to be updated and routed for approvals. I did not use an evaluation, due to the reduced content presented at this meeting, but had many positive comments from staff, primarily telling me they appreciated the comprehensive information and the need to develop this process further. They also stated this created more questions than answers. I asked for clarification of the comment and the group said this brought out many questions about the individualized plan needed for each patient and how the plan will have to be determined based on the other variables at the time. This was the intent of this project. There cannot be one set way to care for the patient in the event of a fire and staff need to be cognizant of the situation and may appropriate decisions. EvaluationThis practicum was developed with three goals in mind, each having specific objectives with related activities and timelines. The majority of the activities for the three goals involved literature review and research to examine and analyze current guidelines and standards. Appendix C provides a copy of the evaluation from the student and preceptor. To summarize the content, I feel I have achieved a greater depth and breadth of the knowledge needed to become a nurse administrator. I have already been in this role, but consider myself a novice in some aspects according to Benner’s examples described previously (Benner et al., 1996). By working with my preceptor and director, I was able to achieve the goals of planning and implementing an educational opportunity designed to create open dialogue to promote safe patient-centered care. The development of research, evidence-based guidelines and current standard reviews was achieved. This allowed me to conduct meetings and have discussions with appropriate individuals in a manner that demonstrated professionalism and understanding of the requirements of an excellent nurse administrator. I was not able to conduct the fire drill to the extent desired, but found the resulting product to be a good starting point for ongoing practices that will include other disciplines as we enhance our knowledge of the care of the patient. To summarize my preceptor’s evaluation of my practicum, I sent the evaluation to Willa and scheduled a meeting to discuss the evaluation. We had a discussion regarding the practicum and my progress throughout the semester. Willa only provided one written comment and expressed her satisfaction with my presentation of the project. We further discussed the activities for this practicum being research and review for the presentation and also for activities such as policy revision or meeting preparation. Willa and I discussed our new relationship that did not previously exist and we both feel this experience was a positive one that we can continue in other opportunities. ConclusionThe practicum developed and presented throughout this course was an excellent opportunity to explore the role of the nurse administrator. The use of research, current standards and regulatory guidelines provide tools to assist the nurse administrator in role performance. The use of ANA Scope and Standards of Practice for Nurse Administrators is a resource for practice standards giving the nurse administrator a base of knowledge to determine the criteria necessary for the role. Issues, concerns and strategies were addressed and analyzed, providing insight into the nurse administrator role. The project developed and presented demonstrates the need for continuing education and the use of open dialogue to care for patients in an emergency situation. The opportunity to explore collaborative efforts to promote growth and change was appreciated. Having mentors to express ideas and receive feedback was helpful and allowed me to use similar approaches within my leadership team. ReferencesAmerican Nurses Association. (2010). Nursing administration: Scope and standards of practice. [Adobe Digital Editions]. Retrieved from , D. A., Occhiuzzo, D., & Douglas, C. (2011). Blueprint for nursing leadership creating a culture of accountability. Nursing Administration Quarterly, 35, 189-196. doi:10.1097/NAQ.0b013e3181ff3af0Association of PeriOperative Nurses. (2012). Perioperative standards and recommended practices. Denver, CO: AORN.Benner, P., Tanner, C. A., & Chesla, C. A. (1996). Expertise in nursing practice ( ed.). New York, NY:Brown, C. D. (2010). The effects of leadership behavior on clinical registered nurse work satisfaction (Doctoral dissertation). Retrieved from , M. E. (2012, October 12). New clinical guidance on surgical fire prevention and management, 1-47. Retrieved from , D. D. (2009). Collaborations in leadership: The nurse case management and nursing administration connection. Professional Case Management, 14, 178-182.ECRI Insitiute. (n.d.). , L. Q., & Sitterding, M. C. (2011). Transformational leadership required to design and sustain evidence-based practice: A system exemplar. Western Journal of Nursing Research, 33, 398-426. safety communication: Preventing surgical fires. (2011). Retrieved from , S. M. (2012). Tap into the power of mentoring how to make mentoring a win for employees, mentors, and employers. Retrieved from , O., Kaarianen, M., & Kyngas, H. (2008). Statistical testing of the full-range leadership theory in nursing. Scandinavian Journal of Caring Sciences, 23, 775-782. , P. (2010, January 31, 2010). Emotional intelligence in the workplace [Online exclusive]. . Retrieved from Dictionary. (2012). Retrieved from , K., Grenny, J., Maxfield, D., MacMillan, R., & Switzler, A. (2011). Change anything: The new science of personal success. New York, NY: Business Plus.Retention shared governance. (n.d.). Retrieved from , W. A. (2010). The relationship between learning styles, emotional social intelligence, and academic success of undergraduate nursing students. Journal of Nursing Research, 2, 136-143.The Center for Appreciative Inquiry website. (n.d.). , J. (2012, May 25). Exploration of transformational and distributed leadership. Nursing Management, 19, 30-34.Warszawski, K. (2012). Safety policy #60 fire plan. Retrieved from BayRegion/intranet/policyandproceduresAppendix AAppendix B Appendix CPreceptor- Student EvaluationNsg 740 PracticumGoal 1: Integrate the AORN Standards and Recommended Practices (2012) and the ANA Nursing Scope and Standards of Practice (2004) into my role as a leader in the Surgical Services environment to improve readiness in the event of a surgical fire during the Fall 2012 semesterObjective1. 1 During the Fall 2012 semester begin implementation of research, education and policy revision for emergency preparedness related to surgical fires at McLaren Bay Region.Activity1.1Begin online research review through Ferris Library also speak with McLaren Bay Region librarian to determine resources available for literature reviewStudent – developed extensive list of resources for use in project. These resources include but are not limited to AORN, APSA, ASA, ECRI, McLaren policies, and FDA. The variety of information and resources provided useful information. I found this information was somewhat overwhelming but gave me a much deeper understanding of the complexity of the issue. Many of these sources are cited throughout the practicum paper and the project PowerPoint presentation.PreceptorObjective1.2 During the fall 2012 semester attend meetings involving key members of the emergency preparedness groups to understand relevant proceedings associated with this practicumActivity1.2 Begin online policy review at McLaren Bay related to emergency preparedness activitiesStudent – meetings were well attended with good open dialogue producing good plan for use in fire drill. This information was also useful for policy review and revision. Members included Bay City Fire Department representatives, McLaren Department representatives from Facilities and Maintenance, Risk Management, Security and Environmental Services.PreceptorObjective1.3 During the fall 2012 semester develop an understanding of the appropriate use of constructive criticism and feedback as it relates to increased effective communication with appropriate members of the facility Activity1.3 Develop ongoing educational materials to assist in the preparation of new students and staff to understand their role in an emergent situation involving a surgical fireStudent – this is ongoing and is being considered for use in other departments such as OB/Women’s Health. The presentation will be presented again and recorded for future educational opportunities.PreceptorObjective1.4 During the fall 2012 semester design an evaluation tool to measure the effectiveness of the educational materials provided to staff as it relates to emergency preparedness presentationsActivity1.4 Develop a measurement tool based on Likert scale to determine effectiveness of teaching methods as it pertains to emergency preparedness presentationsStudent – a specific evaluation tool was not used for this presentation, feedback from the group during post presentation conversations and meetings suggests this presentation was useful and creates a need for further development as well as ongoing educational opportunities. Requests for at least annual education have been suggested. PreceptorGoal 2: Perform a comprehensive fire drill involving multiple disciplinesObjective2.1 During the Fall 2012 semester integrate knowledge involving ANA standards as it relates to emergency preparedness drillsActivity2.1 Develop a drill involving multiple disciplines to determine deficiencies in current fire drill planStudent – the fire drill presentation and simulation provided open dialogue for staff. Due to unforeseen circumstances, a multi-specialty drill was not possible. This provided additional opportunity for OR staff to discuss possible scenarios. Further drills will need to be performed and should involve both surgeons and anesthesia providers. PreceptorObjective2.2 During the Fall 2012 semester design and implement an emergency preparedness drill involving multidisciplinary teams both internal and externalActivities2.2 Develop easy to read evacuation plans that can be carried with team during horizontal or lateral evacuation2.3Present information to members of Surgical Services disciplines including research, plan and information related to drill.2.4 Create scenario related to 2 fire types, one needing to be contained in room and one needing evacuationStudent- this drill provided simulated experiences that only involved a horizontal evacuation and provided experiences that demonstrated the need for further education and training. The evacuation plans include information regarding the Air Handling Units (AHU) used in surgical suites. This information has been proven to be useful for other purposes within the department as we increase our knowledge of best Infection Prevention practices.The drill has also provided a framework to discuss fire prevention for patients including fire risk assessment tools for each patient and procedure. Ongoing communication with all members of the surgical team will be needed to determine how to communicate a standard method to classify this information. PreceptorGoal 3: To assimilate the knowledge and research gathered from the ANA Scope and Standards of Practice for Nurse Administrators and select literature and reference material to advance my practice as a Nurse Administrator.Objective3.1 Review specific standards to prioritize elements that will improve my ability to mentor, influence and foster open communication techniques with colleagues and direct reports. Activity3.1 Review standards and use them as a data source to self- rate and request preceptor to assess my level of proficiency with each ANA Nurse Administrator standard.Student – a comprehensive review of ANA Scope and Standards of Practice for Nurses and Nurse Administrators was used to provide a framework to use in the education and evaluation of processes. This includes but is not limited to emotional intelligence, mentoring, transformational nursing and engagement. Theory including Benner’s Novice to Expert was also used to provide a guide for practicum development. AORN Recommended Standards and Practices were also reviewed and used as a framework to provide education and communication opportunities with surgical staff. Using these types of resources were useful to demonstrate need to use research and evidence to provide excellent patient care in today’s healthcare environment. PreceptorObjective3.2 Perform literature search seeking relevant sources to prepare for practicum work with preceptorActivity3.2 Develop reference list with pertinent material to use a resource for practicum workStudent- as listed above with additional resources from McLaren Leadership Development courses taken previously and during this course. Other sources of information include Mentor program for Employee Engagement activities and McLaren Bay Region Brown Bag luncheon meetings. These sources of information proved to be invaluable as I attempted to improve my practice as a nurse administrator. Willa has also provided some great information from Quint Studer to use as tools to create open dialogue and open communication with employees that may not be reaching their full potential.PreceptorObjective3.3 Perform concise timeline for meeting and assignments with due dates with preceptorActivity3.3 Develop meeting schedule with preceptor including date, place, time and length of meeting with written agendaStudent- meetings were informal and primarily took place during mentor meetings for employee engagement activities. These two programs had parallel purposes and provided me with an opportunity to create a relationship with leaders that may not have occurred previously. I feel this has assisted me in creating other relationships with leaders in our organization and allowed me to improve my communication skills with direct reports and fellow leaders. PreceptorObjective3.4 Assess personal strengths and weaknesses in relation to Nurse Administrator knowledge, skills and abilitiesActivity3.4 Develop priority list of top three areas of weakness and create action plan to improve skill set Student- List of weaknesses was developed and includes delegation, procrastination and time management. These all interrelate and tend to produce a less than optimal work-life balance. An example would be creating a daily activity list and categorizing tasks into like/dislike or easy/hard. I attempted to do one hard or dislike activity before I could do a less than desirable task. This way I would not procrastinate on those less than desirable tasks. This worked about 60% of the time. I also found that priorities changed throughout the day or week and I would feel torn to try to accomplish some necessary items on the list. I also learned to delegate better, but found that those people I may need to delegate to be overwhelmed by their workload.PreceptorSummaryI feel that I have learned many necessary lessons from this course. The goals, objectives and activities were appropriate for the intended purpose. Further work is needed for the fire drill and emergency planning project as well as further development of role as a Nurse Administrator. I feel that continued work will provide me with a necessary framework to provide excellent role modeling and mentoring techniques to enhance my practice. Many relationships have developed and will be helpful in my role. I feel that Willa has used effective techniques to assist me in learning experiences and feel comfortable seeking assistance as needed. I would like to continue to work on my areas of weakness. I would also like to explore the areas of Infection Prevention from an environmental and nursing care perspective. I would also like to develop additional skills involving complex cardio/vascular procedures. This can be accomplished by developing and maintaining relationships with Interventional Radiology teams and Cardiovascular procedural teams. I would also like to continue to work on multi-modality groups to enhance my knowledge of budgetary and market share activities from an administrative role. Further work with groups to improve surgical outcomes will also be explored. Student Lori A. MajeskeDate 12-5-12PreceptorDate ................
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