Preparation for professional practice. The WritePass Journal

Preparation for professional practice.   INTRODUCTION Preparation for professional practice. ) concluded that a lack of awareness and understanding in an organisation’s nursing management theories have shown that the way in which an organisation is managed can affect nurses’ confidence to communicate the need for change. Maddock (2002) argued that the approaches to change and the proposal thereof may be ineffective unless individuals’ management strategies are put in place to develop leaders.   ACCOUNTABILITY/ RESPONSIBILITY According to Marquis et al. (2009) one of the legal requirements of a registered nurse is accountability. Scrivener et al. (2011) identified that accountability involves the ability of the nurse to define every action he/she carries out. The (NMC, 2008) emphasised that   accountability is seen as being of great importance and a qualified nurse is accountable for his/her own actions such as supervision, delegation, creative acts, intervention, assessing a situation or follow-up concerns. NMC (2008) further explained that the entire health care professionals are accountable and responsible for any action, error or omission made in practice. Huber (2006) states that as members of a multidisciplinary team, nurses must maintain their professional accountability. Nurses should also be able to use their communication skills to make complicated information understandable, explain choices, offer reassurance, look out for side-effects and liaise with medical colleagues about the subsequent p rogress of individuals with mental health problems (Garon, 2012). This was seen as a critical aspect of the operation here with regular reviews being planned to evaluate the success of the change and to amend the program where appropriate. Furthermore, if a nurse is meant to delegate care to another professional or support worker, she/he must delegate effectively and should be accountable for the appropriateness of the delegation. During one of the author’s practice placements in the acute ward, a newly qualified nurse delegated the task of security nurse to an agency staff who was very new on the ward. This agency staff let one of the patients out of the ward, not knowing that the patient was on level 1 observation restricted to the ward and the patient absconded from the unit. This resulted in an investigation which revealed that the newly qualified nurse did not delegate the task properly and did not communicate effectively. This raised the question of accountability and responsibility. The specifics of the nurse’s role are identified as being responsible for assessment, planning, the delivery of care and the evaluation of nursing care for their patients (NMC, 2008). According to RCN, 2011), nurses are accountable and responsible, on a daily basis, carrying out patient care most of the time and acting as care provider. Nurses have the responsibility for communicating the relevant information necessary for the patient to receive their full nursing care provision (NMC, 2008).  Ã‚   (RCN, 1992) also states that with an increase in the level of responsibility and accountability, nurses need adequate training and competence to develop these changes. It is the responsibility of the nurses to make sure that patients are suitably dressed and eat their meals, while also managing their welfare rights and dealing with individuals’ psychological distresses; theses roles have to be carried out in conjunction with running organisational demands (RCN, 2011). INTER-PROFESSIONAL COLLABORATION Orchard et al. (2005) described inter-professional collaboration as a combination of different professionals working together in a partnership in order to achieve common goals, establish a therapeutic relationship, showing respect for others and the skilled therapeutic use of self. On the other hand, inter-professional collaboration means the adoption of multi-disciplinary and multi-agency working as the most effective route towards comprehensive mental healthcare (Audrey, 2003). However, Garon (2012) states that when talking about change in inter-professional collaborative team work, it is important to consider how staff members would need to be motivated to accept and welcome this change. It is also very important to select the right leader, which was a key advantage of this approach, to implement the change and involve all team members in the change process, as well as considering the safety of the patients, their comprehensive care and the stress the change might cause (NICE, 200 7b). CONCLUSION During this implementation of â€Å"Protected Mealtimes†, all the team members on the ward worked collaboratively, demonstrated excellent communication skills, showed motivation and were very enthusiastic and committed to the plan. Word count: 2,200. PART 2 THE PROFESSIONAL DEVELOPMENT PLAN (PDP) The purpose of writing this professional development plan is to think and reflect on a facet of the professional development experienced by the author during their three-year course. It will also enable the author to work efficiently and effectively in their areas of weakness and help   to sustain areas of strength, as well as developing delegation skills in the nursing environment, upon qualification. In order to accomplish these goals, a plan utilising SMARTER theory (Specific, Measurable, Realistic, Timely, Ethical and Recorded/ Reflective (Appendix 1) is proposed. During the three years of nursing training, the author of this essay has utilised Gibbs Reflective Cycle (1988), as a framework for reflection on day-to-day actions, strengths and weaknesses. According to Brechin (2000), reflection means not only thinking about a situation, but also using it as a form of systematic appraisal of the events that have occurred and as an examination of an individual’s ability to le arn from the experience and influence future practice. During this placement in the acute ward, the author discovered that delegating duties to staff when co-ordinating shifts was a far more complex issue than originally anticipated. The RCN (2006) described delegation in nursing as a process of entrusting or allocating responsibility to another person who is seen as being able to carry out such a task. The Nursing and Midwifery Council (2008) states that a nurse’s   job cannot be completed or carried out without delegating some part of the care functions to others, as it is highly impossible to deliver total care for different patients with different care needs. Barr and Dowding (2008) in their research emphasised that delegation is a critical leadership skill that must be learned. This became evident when considering a situation which emerged when dealing with a violent patient in a ward environment. In order to delegate tasks relating to this individual it was necessary to use confidence, communication, courate, compassion, competence and care. On the whole this was doen relatively well by myself however it was found that the newly qualified staff nurse is more likely to be unfamiliar with the procedure delegated to him and this made communication a more vital so that guidance could be obtained. Having identified a weakness in the authors ability to delegate, this communication between the two parties in the case mentioned above was used as a clear example of how greater comfort from the process of delegation could be obtained. This would in turn improve confidence. By watching delegations within the ward environment it became apparent to the author that there were greater difficulties when the manager used the autocratic style and this often created hostility amongst other staff and may hinder creativity and improvement. This brought the manager’s delegation skills into question. There was also an increased danger that the more junior member of staff would find themselves unsupervised in an inappropriate and unacceptable way according to RCN (2011). This leadership style as described by Bass 2008 as creating difficulties. Where better delegation communication were used the author was much more comfortable with the delegation process as they were aware that the process would be used appropriately and would be successful. With this in mind the PDP going forward would focus on risk management and controlling the process without following an autocratic style which would lead to loss of control when delegating. CONCLUSION The author of this essay has learned from undertaking this assignment that delegation not only saves time, but is also an essential skill which a registered nurse must posses; it is also requires good leadership and is an important role for every nurse involved in health care delivery. Through this Personal Development Plan (PDP), personal areas of weakness have been identified which the author is currently striving very hard to correct.   REFERENCE LISTS Allan, E., 2007. Change management for school nurse in Scotland. Nursing Standard. 21, (42) 35-39. Allan, E., 1988. 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McKimm, J., and Held, S., 2009. The Emergency of Leadership Theory: From the Twentieth to the Twentieth-First Century. In: McKimm, J., and Phillips, K., eds. 2009. Leadership and Management in Integrated Services. Exeter: Learning Matters. Ch1. National Institute for Clinical Excellence, 2007b. How to change practice. London: NICE. National Institute for Innovation and Improvement, 2013. NHS Change Model: Our Shared Purpose. Tinyurl, com/bwefn79 [Last accessed: May 2 2013]. National Patient Safety Agency 2007.Protected Mealtimes review Findings and Recommendations Report. Nursing and Midwifery Council, 2008. The Code: Standards of Conduct, Performance and Ethics for Nursing and Midwives. London: NMC. O’Connell, B., Macdonald, K., and Kelly, C., 2008.Nursing handover: time change. Contemporary Nurse. 30 (1) 2-11 Creating a Culture for Interdisciplinary. Orchard, C.A., Curran, V., Kabene, S., 2005. Creating a Culture for Interdisciplinary. Collaborative Professional Practice. 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Leading and Managing in Nursing. 5th ed. St Louis: Elsevier Mosby. APPENDIX- 1  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   S.M A.R.T.E.R PLAN          SPECIFICS   Ã‚   Within six months of the preceptor-ship course, there will be a need to build better confidence that will improve communication skills which will support the author in their nursing career. MEASURABLE How can one ascertain that the intended outcomes have been achieved? The learning outcomes will be gained via the professionals consultants, occupational therapist, staff nurses and preceptor-ship mentor involved. The author is confident that these professionals have the necessary assertive skills that will help achieve the desired learning outcomes. Achievable The intention is to attend training courses, discuss any difficulties experienced with the preceptor-ship mentor or manager of the ward or any member of staff, and integrate the proposal as advice. REALISTIC Within three months of completion of the nursing course, it is anticipated that the author will be able to demonstrate effective leadership, delegating tasks properly, and entrusting responsibility to a person who is perceived as being able to carry out these tasks by utilising one’s newly gained assertiveness skills. TIMELY   Within three months of registration, an evaluation of achievements will be carried out and competencies will be examined frequently by the preceptor-ship mentor. The aim is to be constantly monitored by members of the team and to reflect upon performance and the impact of these actions. If there are any obstacles to achieving these goals or any concern from the team about the author’s approach, these issues will be discussed with the preceptor-ship mentor or ward manager, as this will facilitate the development of ongoing skills.       ETHICAL Being knowledgeable about ethical issues such as social and cultural, rights, confidentiality and being aware of how this might impact on one’s practice. As a nurse there is a need to ensure that the patient’s autonomy is respected.    RECORDED/REFLECTIVE Reflection on personal strengths, weaknesses, opportunities and threats (SWOT), on a regular basis.                      Appendix 2 – SWOT Analysis    MY STRENGTHS The SWOT analysis has helped me to develop, maintain a learning environment in which both education and lifelong learning are seen as integral to clinical setting, to work and focus on the goals and strategies, enable me to grab the opportunities I would love to achieve and work very hard to reduce my weakness and increase my strength. With the aid of SWOT analysis, I have been able to identify my strength as being a good team player, good listener, a good communicator and interacting well with my colleagues and patients. Showing compassion to my patients and having the ability to work under pressure. I like taking the lead and I am always happy when people appreciate me, it makes me happy and also motivates me.                MY WEAKNESS I identify my weakness as being easily distracted, tending to carry out many tasks at a time and I am always fearful of making mistakes.   I also felt that there are some areas I lack leadership skills such as being a good delegator because Barr and Dowding (2008) in their research emphasised that delegation is a critical leadership skill that must be learned. I find it complex to delegate duties when coordinating shifts. OPPORTUNITIES My opportunities are to update my knowledge in relation to the new pre-registration courses which include existing educational, personal and professional career development within the establishment.   During this my practice placement I also had the opportunity to learn and share ideas with my colleagues, had the opportunity for questioning and giving feedback. THREATS My threats   Ã‚  are whilst on this practice placement, I found some areas very stressful.   I discovered that some of the mentors were unfamiliar with the new- pre registration programme and unaware of the needs of the nursing students in relation to the learning opportunities or activities . Appendix 3   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Service Improvement Activity – Notification Form Student Details Student SID Number: 0820968 Details of student pledge on which the proposed improvement is based. I must treat individuals kindly and considerately.   I will provide a high standard of practice and care at all times. I will respect individuals’ confidentiality. I must show compassion and unconditional positive regard to my clients. I must disclose information, if I believe some one may be at risk of harming him/her self in line with the law of the country in which I am practising. I must listen to individual in my care and respond to their concerns and preferences. Details of proposed service improvement project/activity: The service improvement initiative is to facilitate Protecting Patient Meal Time in the Psychiatric Intensive Care Unit (PICU).   The purpose of this service improvement is to help and manage mealtimes without unnecessary and avoidable interruptions. Mealtimes are not only a vehicle to provide patients with adequate nutrition, but also provide an opportunity to support social interaction amongst patients. Reason for development: During my practice placement in the PICU. I discovered that there have been a lot of interruptions and argument between some patients and staff during meal time and also staff members who supposed to assist during meal time always claimed to be very busy. This made me choose to introduce to the team about â€Å"Protected Mealtimes†.   This development is to support those patients who were finding it very difficult to eat or drink. Time spent on the project/activity: The service improvement lasted for the period four weeks because I first and foremost had the meeting with the multidisciplinary team members before introducing the change to the patients. Resources used: National Health Service (NHS boarder) Evidence on topic relating Protecting Meal Time Information from in the internet. Policy and regulation from the trust Text book Some information from dietician. Who will be involved? The ward consultant My mentor as a nursing staff, Occupational therapist staff Support worker The ward manager The dietician Myself( a student nurse) Future plans: The future plans are for me to distribute leaflets to the other professionals for them to read it in the internet and be awareness of the protecting meal time. Date discussed with clinical staff in placement area: