DURING THIS PROGRAM, YOU WILL COMPLETE AN EVIDENCE-BASED PRACTICE PROJECT ADDRESSING A PROBLEM, ISSUE OR CONCERN IN YOUR SPECIALITY AREAR OF PROFESSIONAL PRACTICE NUR 513

One area that could be improved on my med-surg oncology floor is in our care for general in patient or (GIP) hospice patients. I think that we could be educated more on what we can do as the nurse in these situations. Such as things that we can say in these situations or things we can do for the patient and their family. I also think that is important to have a proper ratio of 4:1 when caring for a GIP patient. Things like morphine and ativan can be given every 2 or 3 hours and it is important for the nurse to stay on top of this schedule to make the patient comfortable. Also, when dealing with GIP patients, the hospice company usually sends out a representative who checks in on you and the patient and their family which can be very stressful and adds more to an already busy day. I think proper education and just preparing new nurses on our floor would have a greater impact for these patients. 

I think that this area of improvement goes with the theory of peaceful end-of-life. This theory was developed by Cornelia Ruland and Shirley Moore to focus not on death but on creating a peaceful and meaningful living in the life left that one has to live (Micah et al., 2023). I think that a unit based education based on this theory would be very helpful and even a self-reflection of each nurses thought and feelings about death would be helpful in figuring out exactly where needs are in the unit. 

Micah, A., Lita, Affedzie, E. O., Kel, Vera, M., Maame, Yaa, Marva, Roland, B., Johnson, E. J., Vachirawit, W., Ackah, V. A., Maganizo, Quin, C. E., Isik, Sherise, Frank, PAPO, G., Mercy, … Innaya. (2023, October 19). Nursing theories and theorists: The Definitive Guide for Nurses. Nurseslabs. https://nurseslabs.com/nursing-theories/#h-list-of-nursing-theories-and-theorists

DURING THIS PROGRAM, YOU WILL COMPLETE AN EVIDENCE-BASED PRACTICE PROJECT ADDRESSING A PROBLEM, ISSUE OR CONCERN IN YOUR SPECIALITY AREAR OF PROFESSIONAL PRACTICE NUR 513

DURING THIS PROGRAM, YOU WILL COMPLETE AN EVIDENCE-BASED PRACTICE PROJECT ADDRESSING A PROBLEM, ISSUE OR CONCERN IN YOUR SPECIALITY AREAR OF PROFESSIONAL PRACTICE NUR 513

Topic 5 DQ 1

During this program, you will complete an evidence-based practice project addressing a problem, issue, or concern in your specialty area of professional practice. Consider an area in your specialty that you believe needs improvement. Which nursing theories could you apply to this problem? Why is this the best theory?

Week 5 Devotional Question

And when the ten heard it, they began to be indignant at James and John. And Jesus called them to him and said to them, “You know that those who are considered rulers of the Gentiles lord it over them, and their great ones exercise authority over them. But it shall not be so among you. But whoever would be great among you must be your servant, and whoever would be first among you must be slave of all. For even the Son of Man came not to be served but to serve, and to give his life as a ransom for many.” Mark 10:41-45 (ESV)

In this week’s verse, what are your thoughts about our need to be servants to all of our patients or students? And people in the community?

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Jesus Christ is the ruler and the king of this world, He came down in the form of a man and lived his life as we are living in this world. He set the best example for us to follow so we know all things are possible if we set our minds to do it. He as a king, did not Lord over his disciples but rather served them and He has charged each and everyone to serve irrespective of who, what and where you find yourself. Being a leader is not an easy task. It involves a lot of responsibilities and ultimately makes you a servant even though you are a team lead. A leader must ensure that the staff has everything they need to make their work smooth. There are times where some leaders feel they have the final say and would not listen to the voice of their staffs and this makes working difficult and uncomfortable. In such cases they loose their staffs. This is not to say a leader should condone with everything the staff wants, but should have a listening ear and weigh the options, have a discussion with the staff and they come to a unanimous agreement. Leaders serve. They serve students by training them to be the best they can. They serve their team by making sure all supplies are available in the unit or hospital setting. They serve by deescalating issues between patient and staffs. Leaders must be humble, smart and firm and willing to serve both young and old.

My initial reaction to this verse and question was, “I learned something in grad school, ha”! In my last class, we discussed types of leadership and one type of leadership style that really stood out to me was servant leadership. Tarallo (2018) defines servant leaders stating, “They are serving instead of commanding, showing humility instead of brandishing authority, and always looking to enhance the development of their staff members in ways that unlock potential, creativity and sense of purpose”. In relation to nursing, this type of leadership whether in a leader position or as a bedside nurse is putting others before oneself. This can be rewarding and lead to positive outcomes. I feel it is a reminder to put the wants and needs of others before our own. Our feelings on a matter and what we would do should not apply when we are advocating for our patient. In previous discussions, especially when we spoke of the code of ethics for nurses, emphasized the importance of listening to our patients and providing care based on their needs. Servants come in all shapes and styles and as nurses we should be a servant to those we care for and to those we teach. (word count: 202) 

DURING THIS PROGRAM, YOU WILL COMPLETE AN EVIDENCE-BASED PRACTICE PROJECT ADDRESSING A PROBLEM, ISSUE OR CONCERN IN YOUR SPECIALITY AREAR OF PROFESSIONAL PRACTICE NUR 513 Reference 

Tarallo, M. (2018). The art of servant leadership. SHRM. https://www.shrm.org/resourcesandtools/hr-topics/organizational-and-employee-development/pages/the-art-of-servant-leadership.aspx

Servant Leadership is one of my favorite subjects that I taught in another class. I believe nurses are servant leaders. We have had famous servant leaders such as Nelson Mandela, Abe Lincoln, Mother Teresa, Jesus of Nazareth, and many more. We have current day famous servant leaders. Those who are not famous are the nurses among others whose profession or life serves others.

Blessings

I would agree with the above verse. In a world where service to others is the fundamental societal premise, increased peace would be the result. Serving and uplifting others collectively strengthens society as a whole. If the majority of people applied this in the majority of interactions professional and personal what an impact this would have. This would diminish stressors contributing to a healthier society. It is a shame that human nature works against this premise. Most people are focused on personal gain and economic profit. I have embraced and implemented the approach to servant leadership and the results are outstanding. Patient care has improved, the work environment has improved, and absenteeism has decreased. Coming to work is a joy. Collectively we all serve each other and it shows. It is interesting we have one employee who intermittently works in our environment and does not embrace a servant ideology and this has a detrimental effect on our group. This is a tangible event and is noticed by all the other team members. Nursing is a calling to serve others. I have seen many people over the years leave the profession because they entered for economic stability if that is the only reason you became a nurse it is quickly realized that we are grossly under-compensated financially for our burden of responsibility.

Most nursing theories look at the patient as a whole person rather than simply an illness or injury. This approach is called a holistic or humanistic approach which helps foster mental and emotional health aside from physical health. (Paterson, Zderad,2014)

The Humanistic Nursing Theories was created by Josephine Paterson and Loretta Zderad. Humanistic nursing theories essentially nurture the idea that patients can grow in a healthy and productive manner. The humanistic theory focuses not just on the nurses’ medical and scientific background but also on the nurses’ ability to interact with patients. The humanistic theory emphasizes the 

nurse-patient relationship wherein both the nurse and the patient influence the outcome of the nursing interventions. The purpose of this nursing theory is to show that the relationship between the nurse and patient can bring healing as much as the medical intervention. Unlike other theories that generalize the role of the patient, the humanistic model of nursing looks at the patient as a unique individual, and their situation is distinct from one another. This nursing approach has no formula or process to care for patients. Each patient is assessed and treated individually and on a case to cases basis. An example of a concept that needed full attention in the ICU is the introduction of palliative care early in the admission process. We are seeing that physicians will consult the involvement of the palliative care team in the middle or late stage of a patient’s intensive care admission. ICU nurses are proactive members of the ICU team. They are the first healthcare provider to sense if the patient will or will not make it out of the ICU. Often, palliative care consults are driven by the nurse’s desire to support not just the patient but their families. The established rapport of the ICU nurses with the families made it possible for the nurses to know the patient’s wishes in the event of an end of life or death. That’s when nurses will advocate for the introduction of palliative care. There is a misconception about the role of palliative care among patients and their family members. Palliative care is a branch of medicine that focuses on providing relief of symptoms of illness while optimizing the quality of life for patients and families. Research conducted by Fagundes Junior in 2021 showed that in a contemporary CICU registry, comfort measures preceded death in two-thirds of cases, frequently without palliative care team involvement. The high utilization of advanced ICU therapies and delayed and lengthy discussions on comfort measures’ decisions prolong the patients’ and their families’ agony and suffering at the end of life. However, the research also highlights a budding possibility for an early consultation of a palliative care team in cardiac ICU settings to address these concerns. Fagundes et al, 2021). Remember that even at the end of life and death, the patient should be treated humanely and respectfully. Patients should be viewed as holistic beings needing nurturing and care even at the end of their lives. During the patient’s suffering, the palliative care team can provide emotional support and relief from pain through their prescribed interventions. The ICU team should also consult the psychiatric team to ease the patient’s anxiety and emotional distress. The best nursing theory to address the concern for the end of life is the theory formulated by Paterson and Zderad because patients are viewed as holistic beings needing attention addressing not just their physical but, most importantly, their emotional needs. Florence Nightingale Theory of holistic care is also applicable because her theory delve on the philosophy that the provision of care to patients are based on a mutual understanding of their physical, psychological, emotional, and spiritual dimensions.

(Wagner,Whaite, 2010).

Josephine E. Paterson,J.E., Loretta T. Zderad,L.T.(2014).Humanistic Nursing Theory: In Prezi. Retrieved from https://prezi.com/wluuzrylv3nz/humanistic-nursing-theory-josephine-paterson-and-loretta-zd/

Wagner, D.J., Whaite, B. (2010). An Exploration of the Nature of Caring Relationships in the Writings of Florence Nightingale. Journal of Holistic Nursing. 28(4):225-234. doi:10.1177/0898010110386609

Fagundes Junior, A., Berg, D., Bohula, E., Baird-Zars, V., Guo, J., Katz, J., Alviar, C., Van Diepen, S., & Morrow, D. (2021). Palliative care in cardiac intensive care units (CICUs): Insights from the Critical Care Cardiology Trials Network (CCCTN) registry. European Heart Journal. Acute Cardiovascular Care, 10(Supplement_1). https://doi.org/10.1093/ehjacc/zuab020.158

Josephine E. Paterson,J.E., Loretta T. Zderad,L.T.(2014).Humanistic Nursing Theory: In Prezi. Retrieved from https://prezi.com/wluuzrylv3nz/humanistic-nursing-theory-josephine-paterson-and-loretta-zd/

Wagner, D.J., Whaite, B. (2010). An Exploration of the Nature of Caring Relationships in the Writings of Florence Nightingale. Journal of Holistic Nursing. 28(4):225-234. doi:10.1177/0898010110386609

Fagundes Junior, A., Berg, D., Bohula, E., Baird-Zars, V., Guo, J., Katz, J., Alviar, C., Van Diepen, S., & Morrow, D. (2021). Palliative care in cardiac intensive care units (CICUs): Insights from the Critical Care Cardiology Trials Network (CCCTN) registry. European Heart Journal. Acute Cardiovascular Care, 10(Supplement_1). https://doi.org/10.1093/ehjacc/zuab020.158

An issue of particular concern within the entirety of nursing is burnout and mental and emotional fatigue associated with a highly demanding job. This is true for nurse educators who typically take on several roles and responsibilities within academia (Singh et al., 2020). Academic nurses’ stress includes heavy workloads, maintaining a balance between home and work life, issues with support and finding mentors, and adjusting to new positions (Singh et al., 2020). The impact these negative tolls have can be witnessed through the long-term viability of the academic workforce and the increasing need to fill nurse educator positions within schools and healthcare facilities (Singh et al., 2020). For nurses in all settings, it is imperative that they feel confident and supported to do their jobs.

            Kanter’s theory of empowerment can be utilized to provide correlations of negative job contentment such as high employee turnover and low morale (Valdez et al., 2019). It further explains that staff will feel positively enabled to do their job with access to adequate resources, education, possibilities for role advancement, and relationship building within their employment (Valdez et al., 2019). This theory is most helpful to this situation as it highlights the negative impact of poor organizational leadership and employee empowerment which exacerbate an already stressed system for nurses and nurse educators. Recognizing the need to meet these criteria sets a framework for success within the field. It maintains experienced teachers which is crucial to the ongoing quest for excellence in nursing education (Valdez et al., 2019).