Reflective Nurse Practitioner 2 parts

TYPE – Reflective Nurse Practitioner
All of us have been involved in various kinds of conflicts related to our work environment. Using a situation that you were involved in, describe the conflict and how it was handled as an ICU nurse.

• There are 6 prompts that you need to construct a discussion to address for this thread. The sixth prompt uses the word ‘literature’ so please be sure that you include an appropriate ‘in-text’ citation and a corresponding reference citation to support your discussion for this prompt.
• Was the outcome positive or negative?
• How did the involved parties feel about the resolution, did they feel that they were heard, that their issues were resolved in an appropriate manner?
• Based on what you have read in this unit, what could have been done to improve both the situation and the outcome?
• What is professional civility/incivility?
• How does this impact professional relationships an patient care outcomes?
• What incivility literature evidence is available that supports that conflict resolution impacts work environments and patient care?

Students are expected to:

1. Post an initial substantive response of 250 words to each question
2. Respond to at least two other peer/student’s postings with substantive comments
3. The peer postings should be at least one paragraph (approximately 100 words) and include references as indicated by the instructor.
4. References and citations should conform to the APA 6th edition.

Part 2:Rebecca’s Response:

Reflective Practitioner

I had a mental health patient who wanted to commit suicide. This patient needed to be admitted to the mental health unit and observed under a 51/50. The tricky part was that this patient was born a male but identified as a female. The doctor, the mental health nurse, and I were not sure what unit to put this patient in, male or female unit. The patient was requesting to be placed into the female unit but was legally and technically still a male.

This was a difficult situation and we all had different opinions on where the patient should be placed. We ended up placing the patient in the female unit because the patient was already suicidal and felt like she was unable to “fit in” with the world. I think we had a positive outcome because the patient appreciated us placing her in a female unit. The patient felt like we listened to her and wanted to work with her and her point of views. The doctor was the only one who did not agree with the decision and was upset but eventually came to an understanding when he sat down and talked to the patient.

I think that one improvement that could have been made was to discuss this situation without the patient being present so that the patient did not hear us disagreeing on what to do with her. Civility is defined as polite, reasonable and respectful behavior (Watson, & Kaslow, 2016). I think that in the entire situation was civil and handled properly and the patient was treated with respect. I think this has a positive impact on professional relations ships and the patient care outcome. I think that it was good for us, as health care providers, to work together to come to a conclusion. I think that it was also positive for the patient because she felt like she was listened to and that her voice was heard when she normally heels like she is silenced.

ANA’s Code of Ethics for Nurses states that nurses are required to create an ethical environment and culture of civility and kindness, treating colleagues, coworkers, employees, students, and others with dignity and respect (Almost, & Wolff, 2015). Engaging in teamwork requires a clear understanding of positive and negative behaviors that act as facilitators and barriers to healthy workplace relationships. Identifying and correcting underlying barriers, while promoting facilitators, is fundamental to improving care delivery and, ultimately, clinical outcomes. Without civil conflict resolution, patients feel dismissed and that they are not being heard which leads to a decrease in patient satisfaction.

References

Almost, & Wolff. (2015). Positive and negative behaviours in workplace relationships: A scoping review protocol. Retrieved September 30, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles

Watson, & Kaslow. (2016, September). Civility: A core component of professionalism? Retrieved September 30, 2018, from http://www.apa.org/ed/precollege/ptn/2016/09/civil…

Helen’s Response:

• Was the outcome positive or negative

Several years ago, I interview at corporate headquarters for a home health care administrative position. I obtained the position but when I arrived at the agency I was to manage, the environment was dirty, the carpets were old, stained and frayed, and there was black mold around the windows and in the bathroom. I opened a bathroom closet and there was black mold throughout the closet. The outcome was positive after much communication via phone, email, and a site visit by the owner.

• How did the involved parties feel about the resolution, did they feel that they were heard, that their issues were resolved in an appropriate manner?

Initially, I was surprised by the condition of the office. I discussed the issue with the owner of the company. At first, the owner of the company dismissed the information I provided and I did not feel heard. Concerned about the health of myself and the staff, I took photos of the conditions and sent them to the owner. She then made a site visit. During the site visit, she was cordial. After she toured the site, she was apologetic. She realized that the situation warranted immediate attention. I picked out a new office and we moved.

• Based on what you have read in this unit, what could have been done to improve both the situation and the outcome?

The situation would have improved in a more timely manner had the owner not taken an avoidance stance in the beginning. Conflict stems from perceived threat to values, beliefs, identity, security, or interests (Oore, Leiter, & LeBlanc, 2015). Collaboration is required to enhance communication in an effort to understand priorities of individuals and the needs and values of other parties involved in conflict (Rosenstein et al., 2014). When one party presents lack of interest or dismisses the presented issue conflict ensues.

• What is professional civility/incivility?

Incivility is inappropriate, patristic, or insulting behavior at work. One example is a leader who takes credit for an employee’s idea(s). Explosive outbursts are another example of incivility.

Civility is a communicative process that fosters coordinated efforts to establish common ground (Deluliis & Flinko, 2016). Professional civility interjects the common good of a profession into all segments of the workplace, so that professionals feel fulfilled in their professions (Deluliis & Flinko, 2016). Professional civility is the ethical reframing of problematic relationships into opportunities to reclaim the common good of a profession (Deluliis & Flinko, 2016).

• How does this impact professional relationships and patient care outcomes?

Workplace incivility may lead to conflict and conflict at work that is unresolved leads to absenteeism, unsatisfactory performance, low productivity, and greater staff turnover (Oore et al, 2015). Workplace incivility leads to lack of collaboration, is counterproductive, and may lead to sentinel events. In a sentinel event alert, the Joint Commission states that poor communication and ongoing conflict lead to sentinel events in healthcare (Johansen, 2012). The National Patient Safety Foundation advocates for respectful treatment of employees to prevent patient injury (Rosenstein, Dinklin, & Munro, 2014).

• What incivility literature evidence is available that supports that conflict resolution impacts work environments and patient care?

There are a host of articles in the databases. I found four that were used in this post. One article that stands out is Professional Civility and Problematic Relationships in the Workplace (Deluliis & Flinko, 2016).The article is 24 pages in length with a plethora of information on incivility/civility. I also recommend the article on conflict management in the reference list.

References:

Deluliis, D., & Flinko, S. (2016). Professional civility and problematic relationships in the workplace. Communication Research Trends, 35(1), 4-28. URL:

Johansen, M.L. (2012). Keeping the peace: Conflict management strategies for nurse managers. Nursing Management, 43(1), 73-80. Doi: 10.5172/conu

Oore, D.G., Leiter, M.P., & LeBlanc, D.E. (2015). Individual and organizational factors promoting successful responses to workplace conflict. Canadian Psychology, 56(5), 301-310. Doi: 10.1037/cap0000032

Rosenstein, A.H., Dinklin, S.P., & Munro, J. (2014). Conflict resolution. Nursing Management, 45(10), 34-39. Doi: 10.1097/01.NUMA.0000454027.46483.4f

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