Transition to Nursing Flashcards
Stages Professional Role Development – Cohen (1981)?
- Stage I - Unilateral dependence Inexperienced student learns theoretical concepts for role development; applies theory to practice in a limited & supervised way.
- Stage II Negative independence Student has increased opportunities to apply theory to practice & assumes more responsibility; develops confidence & takes on some of the role values; also is more willing to question traditional patterns & ways of knowing.
- Stage III Dependence/mutuality Student is able to be more realistic about role expectations, & questions reflect a higher understanding of theoretical concepts; recognizes role limitations.
- Stage IV Interdependence Student is able to make independent judgments & to take on the professional role; student’s professional identity is more secure & not in opposition with other roles.
Five methods can be used to resolve conflict:
- Avoidance: This is also called withdrawing from or denying conflict. When this method is used, conflict is generally not resolved & may actually be perpetuated.
- Compromise: This approach uses the techniques of bargaining or negotiating. It is recognized that there must be a give & take for the solution to be determined. Generally, compromise works well, although the conflict issue may recur. MyStudyGroup101 LLC ALL RIGHTS RESERVED
- Accommodation: In this method, a person attempts to smooth over the conflict or to suppress the problems. Often, a peaceful environment will be maintained, but one person may feel as though she or he has made a tremendous sacrifice & is inwardly angry & frustrated.
- Competition: In this strategy, one person decides to force the issue & to place personal goals or desires over those of others. This sets up a conflict of power.
- Collaboration: This strategy requires participants to be willing to problem solve & confront the issues with the intent of setting mutual goals. All participants are involved in the decision-making process.
Sources of Resistance - Resistance to change comes from three major sources:
technical concerns, relation to personal needs, & threats to a person’s position & power.
Lowering Resistance - A great deal can be done to lower people’s resistance to change. Strategies fall into four categories:
sharing information, disconfirming currently held beliefs, providing psychological safety, & dictating (forcing) change.
Four management functions are:
planning, organizing, directing, & coordinating.
SBAR / ISBARR?
Introduction Situation Background Assessment Recommendation Read-back
Problem Resolution - The use of the problem-solving process in patient care should be familiar. The process illustrated here includes? (7 things)
identifying the issue, generating solutions, evaluating the suggested solutions, choosing what appears to be the best solution, implementing that solution, evaluating the extent to which the problem has been resolved, and, finally, concluding either that the problem has been resolved or that it will be necessary to repeat the process to find a better solution.
Informal Negotiation process steps? (8)
- Scope the situation. Ask yourself: What am I trying to achieve? What is the environment in which I am operating? What problems am I likely to encounter? What does the other side want?
- Set the ground rules.
- Clarify the problem.
- Make your opening move.
- Continue with offers & counteroffers.
- Set the stage.
- Conduct the negotiation.
- Agree on the resolution of the conflict.
List the Five Rights of Delegation delineated by NCSB?
- Right task
- Right circumstances
- Right person
- Right direction/communication
- Right supervision/evaluation
The American Association of Critical Care Nurses (AACN) recommended considering five factors in making a decision to delegate?
Seven components of the delegation decision making grid:
- Level of client acuity.
- Level of unlicensed assistive personnel capability.
- Level of licensed nurse capability.
- Possibility for injury.
- Number of times the skill has been performed by the unlicensed assistive personnel.
- Level of decision making needed for the activity.
- Client’s ability for self-care.
Five factors to determine if patient care should be delegated:
- Potential for harm to the patient.
- Complexity of the nursing activity.
- Extent of problem solving & innovation required.
- Predictability of outcome.
- Extent of interaction.
Nurses focus care based on the intended outcome of the care or intervention. Alfaro-Lefèvre (2011) provides three levels of priority setting:
■ Use the ABCs plus V (airway, breathing, circulation, & vital signs). These are the most critical.
■ Address mental status, pain, untreated medical issues, & abnormal laboratory results.
■ Consider long-term health (chronic) problems, health education, & coping.
The following are some tips for organizing work on personalized worksheets to help establish client priorities (5):
■ Plan your time around activities that need to occur at a specific time.
■ Do high-priority activities first.
■ Determine which activities are best done in a cluster.
■ Remember that you are responsible for activities delegated to others.
■ Consider your peak energy time when scheduling optional activities.
Steps of Evidence-Based Practice
EBP is a systematic approach to rational decision making that facilitates achievement of best practices. A step-by-step approach ensures that you obtain the strongest available evidence to apply in patient care. There are six steps of EBP:
- Ask a clinical question.
- Collect the most relevant & best evidence.
- Critically appraise the evidence you gather.
- Integrate all evidence with one’s clinical expertise & patient preferences & values in making a practice decision or change.
- Evaluate the practice decision or change.
- Share the outcomes of EBP changes with others.
