Registered nurses are nurses that have passed licensing exams and then graduated from a nursing program. Their scope of practice is judged by legislation governing nurses who are regulated by professional bodies and councils. Drew is a Registered Nurse, who works at a busy 42-bed medical unit. Drew is supposed to be trained based on hospital procedures and policies and variety of skills performed by Registered Nurses. Before Drew can perform his skills without supervision from his preceptor, he should demonstrate his competency check-offs. He has completed 75% of this check-offs before his preceptor goes for vacation. Drew is then given another RN to authorize his remaining skills. Drew notices that the RN is not working well and is concerned that patients may be at risk for infection, and his concern is that he may judge the experienced RN incorrectly.
In nursing, there are gaps between what is learned in nursing textbook, hospital policy, and procedures, published literature and actual practice. All these four are related, and their content is the same. Information taught in nursing textbooks is done according to the hospital’s policy and procedures. These systems include clinical, governance health and human resource policies. Textbooks also show these policies in addition to other topics such as medicine use, information management, and environmental care, planning and providing care. However, in some cases a hospital’s policy and procedures may differ from what the students get from textbooks.
There are also gaps in published literature and the actual practice. In the actual practice, a Registered Nurse experiences what it feels to work as a nurse. A nurse meets patients with different needs and also experiences working with other nurses. In the published literature, Drew may not have encountered a case scenario that is similar to what he is experiencing right now. It is important that a nurse goes through all these learning experiences to make them competitive.
The issues relating to poor management at the medical-surgical unit where infection-control procedure like hand washing and breaks in sterile techniques are lacking signify lack of medical ethics and continuous training. The significance of the scenario is that some of the units taught in nursing textbooks, the hospital policy and procedures, published literature, and actual practice are wide apart and require harmonization as well as continuous skill development. While the hospital has qualified staff, policies and procedures, the management overlooked possible actions by some few staffs that could endanger the lives of the patients. Expressively, the gaps signify need to train staff on measures to take to avoid accidents, infections, contaminations and how to take corrective actions where problems are identified. The gaps shows that there is the need for all to act with due care and observe moral and ethical obligations when dealing with patients and in the preservation of human life. Routine audits and checks have to be implemented in most departments to ensure that the risks are minimized and prevented.
Safety of culture are ways in which safety is managed in workplaces and reflect beliefs, attitudes, values and perceptions that are shared by employees in relation to safety. Safety of culture is expressed in terms behavior, ethics and attitude. An organization’s safety of culture represents an important factor in influencing aspects of organizational safety and human performance. In Drew’s case patient’s safety is at stake. The experienced RN does not perform her skills well. Drew notices gaps in infection control procedures such as breaks in sterile techniques and hand washing. The experienced RN, therefore, needs to be trained in the hospitals safety of culture to avoid endangering patients’ lives. Safety of culture practices mean people act with due diligence to protect not only their lives but also the lives of the people around them. This includes companies taking care of their workers safety more than they do for monetary possession. It implies that Drew need to take responsibility for both positive and negative outcomes associated with her and in case of accidents.
Drew has a role in continuous quality improvement. Since he is already part of the hospital then everything that happens there concerns him. Drew should not ignore things that are being done in the wrong way. He should make sure that he works to the best of his ability as a nurse. This requirement is as per the regulations of a nurse’s policy. Health of the patients comes first, and Drew should always have that in mind to ensure continuity in quality improvement through effective processes, technology adoption and skill development. He should help the organization to come up with the ideas, designs and even the technology to use in the operations of the hospital. Evidently, the hospital has overlooked the possible dangers that could endanger the lives of patients and other staff. It is like it has failed to train employees on measures to take to avoid accidents. In continuous quality improvement process, Drew should push for staff training to impart them with the knowledge needed to take corrective actions where problems are identified, on infection-control procedures, toxic wastage disposal and disaster management. Drew should push for adoption of the continuous quality improvement in the hospital’s regulations on the operations to ensure that the management of takes up full responsibility of the events at the medical-surgical unit and enforcement of the infection-control procedures.
Lindsey and I are working together in a surgical ICU. Her clients complain of pain even after she tells me that she has medicated them. She appears to be short-tempered and jumpy when it comes to working. I am suspicious that she could be using medications that she claims to give her clients. The first thing to be done make sure that patients are being medicated in the right way and then enquire from Lindsey what is going on with her. If Lindsey is taking medicine that is meant for the patients then it is a matter that should be reported to the concerned persons.
In this case, the decision to do nothing may cause patients to suffer which is something that can be avoided early in advance. Another consequence would be Lindsey and I losing our jobs due to misconduct and violating nursing policies and principles. Also, the hospital could be closed due to a fault, and this jeopardizes many people’s lives e.g. employees. It is important, therefore, that the right procedures be taken in this scenario (Alexander, Fawcett, Runcimann, Danielson, 2006).
Nursing policies are applied by all Registered nurses and describe what everyone expects from nursing. The Drew and Lindsey cases are examples in which nursing practices can be a challenge. However, by following the right protocols and procedures, it is a problem that can be dealt with.
Alexander, M. F., Fawcett, J. N., Runciman, P. J., & Danielson, E. (2006). Nursing practice:
Hospital and home. Edinburgh: Churchill Livingstone/Elsevier.