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Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional healthcare team.
The importance of communication in the personal aspect is that creating individual relationship is important and effective communication is essential to achieve this. In addition, when a patient has an important relationship with the care provider, then the assistant will feel that the association is important and will try as much as possible to help such a person, (Macken, 2017). With that being said, when it comes to the therapeutic relationship, the individuals involved in this case will feel that the patients feel that their care providers are the people that are within the framework required for offering them the care they need. Health professionals use therapeutic relationships to help patients and provide them with factual information, so effective communication is crucial. Interprofessional relationships involve the transfer of information and communication between two or more individuals working together. This type of relationship requires for all of the health care members to actively engage and effectively communicate in order to provide adequate patient care and complete tasks accurately.
What similarities and differences can you identify among the above interactions?
The essential similarity that is involved in the among interactions is that effective communication is required amongst the types of relationships mentioned in order for the relationship to function properly. However, the differences involved include the professionalism required in each type of relationship mentioned. For example, interprofessional relationships are more formal than personal relationships.
Explain the concept of congruence between verbal and nonverbal communication.
The concept of the congruence between the verbal and the non-verbal communication is incredibly important. The congruence is that the verbal and the non-verbal congruence has a great association in that verbal situation reveals the information that is communicated via spoken words that the patient may share. Non-verbal communication entails information communicated through facial expressions and gestures. The congruence between these two forms of communication is that they provide health care workers information about the patient’s feelings. Additionally, the nurse may even compare what the patient says, meaning verbal communication, to what the patient portrays, in this case non-verbal communication, and find any resemblance.
There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in a miscommunication. What other method of communication would have been more effective?
Although electronic communication may provide individuals with any benefits, many pitfalls exists with electronic communication. A situation in which electronic communication may result in a miscommunication may be if, for example, an email was not delivered or was delivered late. This miscommunication could have been prevented if a personal meeting or conversation would have been used instead.
How have you seen ISBAR used during your clinical experiences?
In my experience, I have seen ISBAR being used for communication among health care providers. I have experienced that, first, the health care professional introduces himself or herself and gives the reason for calling (I). Then, the situation is explained, including age and gender of the patient and the status (S). The patient’s background is then explained including clinical history and current presenting problems (B). The health care provider then describes the assessment conducted on the patient including their current condition, risks, and results (A). Lastly, the provider calling may make any recommendations of what he or she thinks should best benefit the patient (R).
Develop a hand-off report for yourself.Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form.Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports.
Maria Rodriguez, 68, female, admitted to emergency department. Presented with right-lower abdominal pain and mild fever. Reported severe pain. Patient is stable but continues to report pain. Patient was admitted September 28, 2020 with a past medical history of asthma. Patient was diagnosed with appendicitis. Assessment revealed elevated blood pressure and rapid respirations. Pain assessment revealed an 8 out of a 0-10 scale. Patient was taken in for an appendectomy and is currently stable and in recovery. Recommendations for this patient include further pain assessment. Surgical wound incision should be monitored for any deterioration. Vital signs should be taken regularly.
Dr. Roberts comes into the nurses’station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat,and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond?
As a nurse, I would refer to any personnel and staff member with respect. My initial response would be to talk respectfully to Dr. Roberts and assure him that I will conduct the labs stat. I would further apologize for the delay and explain to the doctor the situation which caused the setback in the labs. For example, I would inform the doctor if my patient had coded or if any accident had previously occurred.
Explain the concept of accountability in delegation. What are the legal ramifications of accountability in delegation?
The concept of accountability means that every person will be responsible for the practices or the conclusions that the person might make in the involved organization. In this delegation, the ramification is that when a person fails to deliver the goals that a person promised or was responsible to deliver, then the person will be held responsible for such a failure in delegation.
Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night.There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.
Using the delegation tree, the nurse must begin by assessing the needs of the patient in order to decide what can be delegated or what has to be done by his or her own (“Ana’s Principles for Delegation,” 2013). The responsibilities of the RN would include severe cases, sterile procedures, IV meal administration, assessment, teaching, and evaluation of patient care. On the other hand, the responsibilities of the LPN might include caring for stable clients and performing routine procedures. Lastly, unlike the responsibilities of the RN and LPN, those that would pertain to NAP/UAPs might involve activities of daily living, for instance, bathing and dressing patients. Furthermore, according to the delegation tree, in order for delegation to occur, a registered nurse must be present to supervise. If this is not possible, the task cannot be delegated.
Discuss the differences between direct delegation and indirect delegation.
A notable difference exists between a direct delegation and an indirect delegation. A direct delegation means that a nurse specifically assigns or delegates a task to another health care worker to perform according to his or her scope of practice. However, in the case of an indirect delegation, a listing of approved activities and tasks is given to the health care provider that were previously established by the agency based on policies of the facility.
You have to observe delegation procedures in your assigned unit:
What considerations does the RN take into account when delegating patient care?
Whenever delegating procedures into the assigned unit, an individual has to make key considerations. Before delegating any task, a nurse must assure that it involves the right person, right task, right circumstances, right directions and communication, and right supervision and evaluation (“Assignment, delegation and supervision: NCLEX-RN,” 2016). What this means is that the right person must be assigned for the right job under adequate circumstances. The nurse delegating the task must provide the other health care provider with the right directions and communications to perform such tasks accordingly. Lastly, the nurse must provide the right supervision and must evaluate the completed task in order to determine the effectiveness of the task and better improve any skills, if needed.
You have to look at the unit census and prioritize the patient care:
Give the rationale for your choices.
As far as looking at the unit census and prioritizing the care of the patient is concerned, the rationale for the choices is that different patients require different care and protection. As an example, some require immediate attention while the others might require care that may be not be so urgent. Therefore, in this case, the patients that require immediate attention will be given a priority while those that do not require immediate attention will be given second priority. The rationale of the choices is that care will be given according to the condition of the patients in that the critical patients will be given a priority while the least affected will be cared for after.
Answer the following questions during your clinical experiences:
What specific tasks did your patients require that you might have been able to delegate?
Patient needs should be evaluated prior to delegating a task and the job should be within the scope of practice of the other health professional in order to provide safety and well-being, keeping in mind the possibility of causing any harm to the patient (Whitehead, Weiss, & Tappen, 2009).The ideal tasks that my patients required that I might have been able to delegate included giving the patient a bed bath and assisting the patient with dressing changes and activities of daily living.
How effective was your nurse/preceptor in delegating tasks to others?
The nurse/preceptor I observed was highly effective in delegating duties to others. The reason is that the nurse would delegate any task that was under the scope of practice of the other health professional. For instance, she did not delegate any assessment, education, or evaluation of any patients, which falls under the RN’s scope of practice.
How did your nurse/preceptor ensure that the tasks were completed safely and appropriately?
The appropriate way that the nurse made sure that tasks were finished appropriately and safely especially after delegating them was by evaluating the task and revising the work done after being completed. Additionally, after delegating a task, the nurse would still supervise the assigned health professional and would allow him or her to ask any question or clarification in case a need arose.
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