nurse administrator practicum - lori majeske … · web viewa project exploring a surgical fire...

Running head: NURSE ADMINISTRATOR PRACTICUM 1

Nurse Administrator Practicum

Lori A. Majeske

Ferris State

NURSE ADMINISTRATOR PRACTICUM 2

Abstract

The 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

communication


Nurse Administrator Practicum

The 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 inquiry


The 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.

Mentoring

The 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 intelligence

Emotional 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 leadership

Transformational 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.

Planning

This 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

Lori, 12/12/12,

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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 utilization

The 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.

Project

As 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.

Evaluation


This 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.


Conclusion

The 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.


References

American Nurses Association. (2010). Nursing administration: Scope and standards of practice.

[Adobe Digital Editions]. Retrieved from http://www.Nursesbooks.org

Aroh, 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.0b013e3181ff3af0

Association 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 http://www.ferris.edu/library

Bruley, M. E. (2012, October 12). New clinical guidance on surgical fire prevention and

management, 1-47. Retrieved from

http://www.aorn.org/Events/Webinars/Upcoming_Webinars.aspx#SurgicalFirePrevention

Carr, D. D. (2009). Collaborations in leadership: The nurse case management and nursing

administration connection. Professional Case Management, 14, 178-182.

ECRI Insitiute. (n.d.). https://www.ecri.org/Pages/default.aspx

Everett, 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. http://dx.doi.org/10.1177/0193945910383056

FDA safety communication: Preventing surgical fires. (2011). Retrieved from

http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm275189.htm


Heathfield, S. M. (2012). Tap into the power of mentoring how to make mentoring a win for

employees, mentors, and employers. Retrieved from

http://humanresources.about.com/od/Mentoring-Learning-Orgs/qt/mentoring-

employees.htm

Kanste, O., Kaarianen, M., & Kyngas, H. (2008). Statistical testing of the full-range leadership

theory in nursing. Scandinavian Journal of Caring Sciences, 23, 775-782.

http://dx.doi.org/10.1111/j.1471-6712.2008.00663.x

Kiracofe, P. (2010, January 31, 2010). Emotional intelligence in the workplace [Online

exclusive]. . Retrieved from http://www.articlesbase.com/training-articles/emotional-

intelligence-in-the-workplace-1804073.html

Merriam-Webster Dictionary. (2012). Retrieved from

http://www.merriam-webster.com/dictionary

Patterson, 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

http://www.healthworkforce.org/guide/Shared-Governance.htm

Suliman, 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.).

http://centerforappreciativeinquiry.net/2011/04/27/what-is-appreciative-inquiry/

Tomlinson, 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

www.mclaren.org/BayRegion/intranet/policyandprocedures


Appendix A


Appendix B


Appendix C

Preceptor- Student Evaluation

Nsg 740 Practicum

Goal 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 semester

Objective

1. 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.

Activity

1.1Begin online research review through Ferris Library also speak with McLaren Bay Region librarian to determine resources available for literature review

Student – 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.

Preceptor


Objective

1.2 During the fall 2012 semester attend meetings involving key members of the emergency preparedness groups to understand relevant proceedings associated with this practicum

Activity

1.2 Begin online policy review at McLaren Bay related to emergency preparedness activities

Student – 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.

Preceptor

Objective

1.3 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

Activity

1.3 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 fire

Student – 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.

Preceptor


Objective

1.4 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 presentations

Activity

1.4 Develop a measurement tool based on Likert scale to determine effectiveness of teaching methods as it pertains to emergency preparedness presentations

Student – 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.

Preceptor

Goal 2: Perform a comprehensive fire drill involving multiple disciplines

Objective

2.1 During the Fall 2012 semester integrate knowledge involving ANA standards as it relates to emergency preparedness drills

Activity

2.1 Develop a drill involving multiple disciplines to determine deficiencies in current fire drill plan

Student – 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.

Preceptor


Objective

2.2 During the Fall 2012 semester design and implement an emergency preparedness drill involving multidisciplinary teams both internal and external

Activities

2.2 Develop easy to read evacuation plans that can be carried with team during horizontal or lateral evacuation

2.3Present 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 evacuation

Student- 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.

Preceptor

Goal 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.

Objective

3.1 Review specific standards to prioritize elements that will improve my ability to mentor, influence and foster open communication techniques with colleagues and direct reports.

Activity


3.1 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.

Preceptor

Objective

3.2 Perform literature search seeking relevant sources to prepare for practicum work with preceptor

Activity

3.2 Develop reference list with pertinent material to use a resource for practicum work

Student- 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.

Preceptor


Objective

3.3 Perform concise timeline for meeting and assignments with due dates with preceptor

Activity

3.3 Develop meeting schedule with preceptor including date, place, time and length of meeting with written agenda

Student- 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.

Preceptor

Objective

3.4 Assess personal strengths and weaknesses in relation to Nurse Administrator knowledge, skills and abilities

Activity

3.4 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.


Preceptor

Summary

I 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. Majeske Date 12-5-12

Preceptor Date

nurse administrator practicum - lori majeske … · web viewa project exploring a surgical fire...

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