My Learning Experience

My Learning Experience

Practicum Summary

My nursing practicum experience was one that I thoroughly enjoyed working with an experienced nurse preceptor at the hospital. The purpose of this experience was to examine and learn more about myself as a future leader, my leadership abilities and create a network of connections with individuals who have been in this position previously to guide me along the way. In order to be successful, I had to take the lead by identifying my strengths, weaknesses, and areas of growth opportunities. My experience allowed me to put theory into practice as it gave me an opportunity to explore real-life situations that could be used in future experiences after graduation. I attended this practicum to gain more knowledge about leadership abilities or management skills.

Objectives

Given objectives: Upon graduation from nursing school, the successful candidate will be able to demonstrate knowledge of current trends in leadership and management theories and implementation strategies related to nurses within a health care context. The individual should understand the relationship between policy development and program implementation and understand interdisciplinary collaboration’s impact on patient care and organizational outcomes. The candidate should demonstrate an ability to adapt management strategies in response to change, demonstrate critical thinking skills related to applying current leadership theories. This was mainly achieved through my preceptor teaching me about being a charge nurse or managing leadership roles within the hospital setting known as “management” to the nurses.

Personal Objectives: Develop skills in assessing individual skills and abilities, identify teaching/coaching opportunities, manage patient care challenges. I personally met my objectives by informing myself about being a charge nurse or having leadership roles within a hospital setting. I was able to better understand how this works by listening to the preceptor, who explained how I would be managing this area of care. The individual should understand the relationship between policy development and program implementation and demonstrate the ability to adapt management strategies in response to change.

How Evidence-Based Practice Was Examined And Is Applied Or Not Applied In The Setting By The Leader In The Work Setting

My preceptor used evidence-based practice as she had a great knowledge of it and implemented this within the work setting. She told me that evidence-based practice is considered to be “what must have been done before,” which helps her provide care based on what has been proven useful or not useful for patients. This helped my preceptor better assess her patients, identify teaching/coaching opportunities with the nurses under her, and adapt management strategies when needed. The preceptor also considered evidence-based practice when it came to the hospital’s policies, not just patient care. They would research and look into different policies that could be useful or not useful for patients and then what they felt was the best option for patient care. This helped them adapt management strategies to better suit patient care.

My preceptor was also knowledgeable about this because she had previously worked in different hospital areas, all managed differently due to their policies implemented within that area of care. This allowed her to develop more skills when assessing individual skills and abilities. For example, she knew each person’s skill level under her charge because she had worked with them in different settings. Evidence-based practice also came into play for the co-workers who were not nurses. She would have to implement evidence-based care when working with other people, such as physicians or therapists, to ensure her patients receive the best care possible.

There was no question about whether the evidence-based practice was applied in the work setting because my preceptor knew her stuff and had confidence in what she did while also knowing when to change management strategies if need be. My preceptor related pharmacology, pathophysiology, physiology, etc., back to how it would help them in their role, and I also helped with this when we had to discuss patient care together.

The outcome measurements that I observed were vital signs, weights, and intake/output (I/O) measures to ensure patient stability and plan further care. These measurements were important because they helped the preceptor decide what actions would need to be taken next to provide them with the best possible care. If a patient was not doing well in terms of vital signs, my preceptor would talk with the patient to find out how they were feeling or what was going on. This helped her assess the situation better by knowing exactly what she was dealing with and allowing for a plan of care that best suited the patient’s needs. I/O measures helped them determine if their patients were eating well enough or not. They are important because if the patient is not eating well, it will affect their I/O measures, which can be an early warning sign of possible problems in the near future.

My preceptor would take these measurements every shift to identify what was going on with her patients at all times and ensure they were receiving the best care possible. If any changes needed to be made, my preceptor would make her assessments known and then plan for further interventions that would help support patient goals or prevent potential issues or complications in the future. Also, these measurements allowed her to see if there were needed adjustments to the plan of care, making her practice more evidence-based.

My preceptor’s leadership style was very collaborative, as she involved all team members in discussions and problem-solving when needed. This was achieved in different ways, involving individuals who worked under her charge (nurses) and those outside of that group (physicians, therapists). I feel that the collaborative style was effective because it promoted teamwork and allowed everyone to feel as though they could provide input into their day-to-day work. It also encouraged different ideas to be brought forward and discussed, such as improving processes or making certain aspects of the job easier. I believe it was significant because if everyone feels they are part of the working team, they will also feel valued and supported. This in turn is important for patient care because if nurses are feeling good about themselves, it will translate into how they work with patients, which is something that everyone involved would benefit from.

My preceptor’s style was very effective in this type of environment because she used many different leadership styles, which is important in a hospital setting where things are constantly changing. She had the ability to approach situations from many different angles, allowing her to use each of them appropriately according to what was needed at that very moment. It also allowed her to stay informed of everything happening on the floor but prevented her not to become overwhelmed or bogged down by the things that were happenning around her.

For example, during my time with my preceptor, she experienced a cardiac arrest in which the patient was not responding to CPR. This is an extremely serious situation because there is no electrical activity within the heart, and if left untreated, death will ensue shortly after. In order to save this patient’s life, my preceptor had to work quickly in finding out what had happened and why she was taking care of other patients on the floor. She began by checking every patient in the unit for signs of internal bleeding, which could have been causing cardiac arrest due to a compromised blood flow. After no signs were found, my preceptor quickly and accurately assessed what situation had occurred and how they could fix it. It was quickly determined that the patient had most likely broken their leg which had happened during the fall, putting them into cardiac arrest due to pain, blood loss or both. This assessment also meant my preceptor needed to figure out how this could potentially be prevented in the future. The team gathered around her as she explained clearly what they were going to do next while involving everyone in the conversation. She had some nurses get all of the necessary equipment ready, and another person began drawing up medication that would be used for pain relief after surgery. Another person called radiology to see if they were available right away for a possible X-ray, and finally, she sent someone out to get an urgent bed and to notify the family of what was happening and why. She worked quickly and sternly but at the same time never raised her voice or used any demeaning words. This meant that everyone on the floor knew exactly what they needed to do and where they were supposed to be at all times while still maintaining a non-threatening environment for all staff members to work in. This type of leadership style is important because it allows for all voices to be heard without fear of reprimand or negative judgment, which empowers everyone on the floor and allows them to do their job properly.

Literature Review

According to Chiok Foong Loke (2001), nurse manager communication style and leadership behaviors significantly affect employees’ perception of their work environment, which affects job satisfaction organizational commitment. Also, communication style influences how well nurses can care for their patients. This means that communication is extremely important in hospital settings, especially when it comes to managing people and ensuring that good communication exists between employees, so everybody knows exactly what they need to be doing at all times (Chiok Foong Loke, 2001). This also means ensuring good communication between the manager and the employees. This enables them to work together to produce a positive result for everyone involved and allows all voices and ideas to be heard, so no one feels left out or unimportant. This also helps to promote collaboration and engagement, which means employees are more likely to want to work hard for the organization because they feel like their opinions matter.

Another article by Anonson et al. (2014) stated that open communication is one of the most important qualities in nurses in leadership roles because it allows for collaboration among staff members and other members outside of their department they may interact with regularly. By having this relationship between different groups within an organization, everyone can work together to achieve similar goals. According to this article, open communication is vital to be successful because it allows people to feel safe and comfortable talking with others about problems that may arise or concerns that they may have, regardless of how big or small the issue is. It also allows nurses to lead by example and encourages teamwork among peers to help each other and their patients.

This article also states that effective communication is even more important in areas with a high-stress environment, such as the post-operative care unit (Anonson et al., 2014). This is extremely relevant because I observed this firsthand during my practicum experience. The nurse manager working with us on this floor made everyone feel safe and comfortable, even the most inexperienced nurses such as me. This meant that everyone knew what they were doing and where they needed to be at all times, but it also allowed for any questions or concerns to be raised without fear of repercussion, which enabled nurses to do their job properly and care for each other and their patients in a more efficient manner.

The article also stated that it is significant for nurses to practice openness and honest about the issues they are going through on the floor because not only does this empower staff members tocarry out their duties properly, but it also helps managers work effectively when improving care plans and identifying different patients’ needs which makes them better leaders overall (Anonson et al., 2014). It is important to use communication to improve and shape an environment conducive to success. This can be done by using communication tools such as an open-door policy, allowing for communication without fear of repercussion, ensuring all voices are heard, and allowing freely sharing ideas. By building relationships with employees and allowing them to feel like they are part of the organization, nurses can increase their self-efficacy and happiness, which helps to improve the overall effectiveness of everyone involved (Anonson et al., 2014).

The other article that I found was about effective communication between nurse managers and nurses on post-cardiac surgery units (Abrogar, 2020). The first finding was that communication is important because it allows for conflict resolution, establishes links between nursing and management, and also because communication is a two-way process (increased mutual understanding) (Abrogar, 2020). The authors found that nurse managers need to communicate in an open-minded way to positively influence nurses who work with them. This means that nurses need to communicate with their managers in a respectful way that allows them to feel heard and validated instead of feeling like they are being addressed in a manner where everything is an attack (Abrogar, 2020). The authors concluded that communication is critical for nurses and nurse managers to work together to improve patient care, improve hospital operational efficiency, and increase job satisfaction (Abrogar, 2020). Managers must be open with nurses to understand what they are doing wrong or where their skills need improvement. This helps make for an effective two-way communication process that allows best practices to be shared across the board. Also, this increase in communication can also foster teamwork between nurses and managers, making for a more harmonious working environment overall.

These articles are extremely relevant to my learning experience throughout my practicum because they touch upon issues that I observed firsthand while working at the hospital. It has been my experience that there is a lack of communication between nurses and their managers, which results in poor teamwork and frustration on the unit (in my opinion). I think this could be alleviated if managers took the time to build relationships with their employees by taking an interest in them as people rather than just workers.

Conclusion

I believe that communication between managers and their nurses is very one-sided. I could not find any articles that talked about nurse managers as having a responsibility to listen and speak for the communication process to be successful (although we discussed this briefly in class). I think it would also help everyone involved if there were less of an “us vs. them” mentality between how nurses perceive management and how management perceives nursing. I’ve noticed that there is often some friction between the two sides which would benefit from a more open-minded discussion where blame doesn’t need to be placed upon anyone in particular. Increasing communication by making it feel like a mutual process instead of just managers talking at nurses would benefit everyone involved. This would increase the likelihood that patients will receive the best care possible because there won’t be any misunderstandings between caregivers and providers. I also think it would help nurse managers feel more appreciated by their employees, making them feel happier with their jobs overall.

This is an interesting topic because communication is a key component of any relationship. Suppose communication with a co-worker or in an organization isn’t done well. In that case, it can be extremely difficult to get anything accomplished because employees won’t feel like they’re on the same page, and their goals will not align with that of the company or team. I think what makes this topic interesting is that this is a very common issue that can be prevented easily with some simple changes to how managers and nurses engage in dialogue. I think it would have been beneficial for our instructor to have focused more on how the nurses need to listen and speak when trying to communicate with their managers during our class discussions. I feel like this is a very important piece of communication that is often overlooked, and it makes me wonder why this component wasn’t covered.

References

Abrogar, J. (2020). Improving Medication Communication of Nurses to Patients in the Cardiac Procedure Unit.

Anonson, J., Walker, M. E., Arries, E., Maposa, S., Telford, P., & Berry, L. (2014). Qualities of exemplary nurse leaders: perspectives of frontline nurses. Journal of nursing management, 22(1), 127-136.

Chiok Foong Loke, J. (2001). Leadership behaviours: effects on job satisfaction, productivity and organizational commitment. Journal of nursing management, 9(4), 191-204.