Percentage: 40% Word count: 2000 word (±10%) excluding in-text citations & reference list.
This assignment is divided into 3 parts:
1. Reflect on how organisational structure and organisational culture can affect the safety of person-centred care delivery. (SILO 3)
2. Reflect on the skills related to health information systems. (SILOS)
3. Develop awareness of the transition from students to registered nurses through critical self-reflection. (SILO 6)
You will be required to reflect upon your own clinical experience to date and to search for evidence from the literature to address questions regarding contemporary professional practice. This reflection follows the underlying principles of Gibbs' reflective cycle (1988) on description, analysis and action. You do not need to explain or follow the specific questions of the Gibb's cycle in your work. As this is reflective writing, it is appropriate to use a first person writing style. However, you should support your opinion and arguments with current (unless it is seminal work) and peer reviewed evidence from the literature, especially in the analysis section.
SILO 3 Organizational structure and culture (650 words)
✓ Rationale: As a graduate nurse, you may not always feel comfortable speaking up when there is a safety concern. It is important to reflect on systemic and personal factors that promote safety culture.
• Describe a time in your clinical placement as a student nurse where there was a safety concern. How was this dealt with? Were you or other nurses able to speak up for safety? [150 words] o Analyse what kind of organisational culture makes it possible for you to speak up? What kinds of structure or systems exist in a workplace that makes it possible for you to speak up? E.g. Melbourne Health's Safety Culture Program, Mildura Based Hospital's 'Speaking up for safety' (can be found in assessment resources folder). [300 words] o Reflect on what role you have as a graduate nurse in speaking up to promote a safety culture? (action) [200 words]
TITLE OF THE ASSIGNMENT- REFLECTIVE PRACTICE ON NURSING AND WORKPLACE SAFETY
The profession of a nurse is highly rewarding, and as a graduate nurse, I felt the need to raise the bar of awareness when it comes to safety within the healthcare system. There was a time in my clinical placement when I was a student nurse where there was a safety concern which was needed to be brought to attention in front of other healthcare workers as well. I, unfortunately, injured myself at work during my training process, and I felt that I should be entitled to a safe workplace. It was a safety concern which I dealt with by talking to the administration and others in charge of policies to make sure I got compensated. ("About the Australian Nursing & Midwifery Federation", 2020) Nurses are always entitled to a healthy workplace where they deserve rehabilitation and compensation if they get hurt or injure themselves at the workplace. Highest standards of workplace safety are one of the laws that every government should impose on healthcare institutions.
Both systematic and personal factors are considered important in promoting a safety culture. Having a strong fundamental organizational culture helps in speaking up. Various types of structures exist in the workplace, making it possible for speaking up, such as the Melbourne health’s safety culture program. This program promotes Melbourne health through healthy workplace structures and ideal safety practices to support staff. The primary objectives of promoting a safety culture are the improvement in quality in the organizational structure to prevent errors. (Nursing and Midwifery Board of Australia. 2018) It is essential to speak up for safety to form a culture where staff empowerment is designed in such a way so that it bridges the gap for sharing concerns and talking about safety at workplace amongst each other. If a particular staff is not abiding by the safety protocols or his or her behavior is affecting others, then this should be brought to notice. It should ensure ways to share feedback so that proper training gets arranged after that. Last but not least, in health safety culture program, leadership development is extremely crucial. Leaders are responsible for creating a positive environment that focuses on work safety and behavior. (Secretary, 2020)
Another system of speaking up for safety focuses on creating a reliable culture. Nursing staff should be able to speak up for the rights or any issue that can arise at any point of time within the organization. If being a working nurse in a healthcare institution, I feel that the organization truly cares about safety and health, I would recommend their services to my extended family. Any organization needs to encourage its staff to speak up about safety and to promote a healthy culture. Leadership commitment is vital to ensure the team feels comfortable in sharing their views and opinions. All the staff should be trained in a common language to avoid barriers in communication at the time of execution. Any errors in understanding can lead to harm. (Edcan.org.au, 2020)
Nursing career is a significant part of the healthcare system. Just like how a healthcare system is incomplete without doctors, nurses play a vital role in taking care of various patients from time to time. As a nurse, I felt communicating with other nurses are a requirement in this profession. Therefore like I would like to guide my colleague wherever necessary, I would expect the same from them as well. It is crucial to improve professional accountability in these matters within the organization. In my opinion, a patient’s safety has due importance when more than one staff is willing to talk about the safety issue. We should respect each other and creating a friendly yet professional environment where awareness can be raised easily about patient safety. (Nursing and Midwifery Board of Australia. 2016)
Each and every one should normalize speaking up and should make sure this becomes a necessity to work in a healthcare profession. It should be adapted as a mandatory framework to ensure everybody has an equal role in ensuring the patient’s safety. If being a nurse, I feel something else can cause harm to the patient unintentionally, of course, and it is my responsibility to intervene right there and stop the mistake from taking place. (Murray, 2020)
The privilege of working as a nurse in the safe environment of the hospital in Melbourne provided me with the chance to observe the benefit of the health informatics system when a patient was admitted in the late of the night at our clinical placement while he was suffering from asthma attack since the evening. The patient information system initiated immediately, which primarily reduced the time of identifying the primary concern of the health condition of the patient (Miles et al. 2019). This helped us understand the co-morbidities while the physician advised the medicines as diagnosed from the symptoms accurately benefitting the patient from an adverse drug reaction.
As informed by Biggs et al. (2019), the barrier that has been challenging in utilizing the health informatics system through the Electronic Health Record is the lack of awareness and training among the staff. The experience which I confronted in the workplace environment was related with my colleague who was assigned to record the primary information of a patient admitted in the emergency ward while she was not aware how to use the record. This was the barrier caused due to poor attention and time pressure with a compelling heavy workload in the hospital. I had to intervene with my expertise and knowledge to help her out. I learnt that even the system installed with the hospital was not updated, which created more difficulty in accessing the accurate information of the patient. Hence, it is evident that incorporating user-friendly interface to use the health informatics system will enhance the service quality provided by the nurses.
The challenge faced by me while assisting my colleague using the health informatics to comprehend the patients’ health information was poor integration of the information available and accessed through the traditional method. Even the flow of patients, attending the emergency patients, working on the observations, medications and proper care for the patients within short deadlines takes away the enthusiasm to concentrate on the digital transition and usage of the information through the digital platform (Debono et al. 2017). The authority is also responsible for ensuring the easy to access health informatics which helps in saving time and effort. However, the lack of management and sincerity in updating the information leads to the emergence of such obstruction. The devices used in the hospital premises need up-gradation to various health apps, and the authority can indulge in creating an indigenous app for the convenience of the patients and health workers. It was also observed by me that the devices were used multiple times without proper security to the information which may cause a breach to the privacy of the patients (Byambasuren et al. 2020). Hence the obstacle of training and lack of awareness is coupled by a lack of authentic source accessed.
The nursing profession has evolved with substantial duties and responsibilities which reflect on the ethical practices of the nurses while acquiring knowledge on the health data and medical concepts in conjunction with information technology. This assures in better patient outcome while tracking the complex health-related problems (Rasheed et al. 2019). The ethical use of the health informatics is beneficial while tracking the chronic diseases of the patients or attending emergency patients which involve accurate medical intervention with no adverse medication effect. The role played by us as graduate nurses in ethical usage of the health informatics system is evidence-based practices associated with the wellbeing of the patients. (Nursing and Midwifery Board of Australia. 2018)
The better access to the health informatics used ethically in the daily practices ensures better coordination in the patient care while collaborating with the health care workers and incorporating more personalized medical and various other interventions as and when required. We as a graduate nurse are instrumental in addressing the documentation of the vital statics of the health of the patients, keep track of the improvement or deterioration and follow-up with the process (Hubner et al. 2018).The ethical access of the health informatics supports in the assessment of the health records, a preliminary diagnosis of the patient, closely monitoring the medical interventions and evaluation of the patients’ response to the treatment.
The healthcare environment is complex and challenging. The graduate nurses face several complex environments in their transition period from a trainee to be a registered nurse. The primary challenges identified by me while being an intern is the lack of experienced and empathetic mentors and performance anxiety and being bullied in the workplace environment. However, the latter is succinctly meant as the healthcare organizations are careful in choosing the policies of assuring a healthy and safe environment for their staffs. The first aspect that can be highlighted as a hurdle is the workload faced by the young nurses like us while we feel the lacunae of experienced mentors who can empathetically train us in the trade (Dyess et al. 2016).
The first phase of transition from graduate trainee to being whole time practitioner as a registered nurse brings more responsibilities and fatigue while managing the patients, the healthcare practitioners, colleagues, administrations and family. The environment in the hospital is more chronic with the regular inflow of patients with various diseases that requires definitive support both mentally and physically (Berry et al. 2016). This tends us to provide them with both which physically and mentally exhaust us. Moreover, experienced nurses tend to be less empathetic to the new joiners while establishing their leadership in the workplace environment.
The other challenge faced during the transition is the anxiety of performance and subtle bullying of the seniors. The expectation of one's own performance is always high with the motivation of serving more people. However, what I have experienced in this transition is the anxiety of performing in front of my seniors in much organized way which could not take place due to several reasons. One of them was subtle bullying in the way which is not practically evident while more tasks were allotted to me with less freedom and time to manage them simultaneously.
The workplace attitude of registered nurses or graduate nurses as trainee must be equivalent like other professions where they display the best of their actions and positive attitude to the trade job. Being in this profession, I have learnt that despite fatigue and stress it is important to put a smile to work and provide active listening to the patients who are more stressed and hapless in their physical and mental state (Delgado et al. 2020). The two positive behaviors that I have incorporated in my daily routine is to offer SMART work which stands as an acronym to specific, measurable, achievable, realistic and timely. I have incorporated effective communication skills which would enhance my performance with the patients and their families.
The second positive activity which I have incorporated in my daily routine is to be open-minded in the workplace environment. I need not be assuming or judging someone, which will unnecessarily add on to my stress (Terzioglu et al. 2016). On the contrary, I would focus how to develop my skills to enhance better patient outcomes with the implementation of evidence-based practices in the hospital to enhance my knowledge and expertise. I would also positively engage with the patients and their feedbacks to improve the ways that I can serve the patients while focusing on their wellbeing.
Self-care is the best healing practice in which I can indulge after a hectic work schedule. The self-care strategies that I have developed in my daily routine are to practice meditation for an hour which will help me rejuvenate spiritually and emotionally. This will disconnect me from all the pain and trauma for a specific time while I can connect with the universe to gain a healthier understanding of self-enhancement.
The other self-care strategy that I wish to implement is to socialize with people with a positive attitude towards life and who can empower me from within (Hutchinson et al. 2018). I will indulge myself in a healthy discussion on various topics which can enrich my knowledge while emotionally nurturing me from the stressful environment that I have to encounter in the workplace environment.