Transitions to Professional –practice

Table of Contents

Transitions to Professional –practice. 1

Assertiveness: 2

Assertiveness aided leadership: 2

Assertive communication: 3

Case scenario: 3

Reflection through Rolfe model: 4

What?. 4

So what?. 4

Now, what?. 5

Discussion: 5

The present healthcare environment is getting tougher day by day for a nurse to stay focused on the job. I, as a nurse has to be assertive as well as I have to brush up my leadership skill and communication skill to cope up with my job profile.

Assertiveness: Assertiveness is crucial in nursing to handle the situations of complex human relations and assertive communication skill is the most valuable and considerable things are to be accrued for a nurse like me. I can value myself as well as my job if I can be assertive. Clarifying my professional values may be the best option for initiating change and expanding my awareness. For betterment, I can ask myself the questions like, who am I? What is more valuable for me in the work field? What is my career goal? How can I reach the goal? And these questions can offer a path for career growth as well as effective in leadership skill of nursing (Powell and Newgent, 2011). It is neither an inborn personality trait not determined by a gene, but rather a cultured skill that I need to practice consistently. If I want to explore on the question like which types of outcome should I expect after the development of assertiveness skill? It seems that it can increase the creativity of a nurse in the professional front as well as in personal power (Kammrath et al., 2015). Self-understanding and useful techniques of dealing with others are naturally coming out on being assertive. When one nurse like me goes through the change and become more assertive, things are needed to know and examine (Ockey, 2011).

 A disturbance within our work and social life gets created when we start to change our behaviour and values and to experience new path. Still there are several barriers to assertiveness, like self-dialogue, myths, rigid requirements, risking and conscious choice and negative labelling. A study including 207 nursing student in Port Said University showed 60.4% were assertive. On the result, the study recommended the particular course to improve the assertiveness skill acquisition. The concept of androgyny has been denied by the obstacle to the assertiveness of rigid requirements. The equilibrium of androgyny is vital for assertiveness because it gives the opportunity to a person to be a leader who is truthful and direct, to express emotion. I can assume myself assertive only when, every person will like ne in any case, I can be unassuming, I know the actual result, and any one will get angry for my behaviour (Cutright, 2011). In organising for an assertive encounter, giving positive statements to own self is a good way. Statements like, I can express my feelings as I wish, and everyone does not need to approve or like me. There are several areas of a problem of assertive behaviour. One has to deal with the criticism. Expressing anger, setting limits, saying no and also expressing private initiative are also some most common problem that should be consistently kept in mind in the time of transition (Ibrahim, 2011).

Assertiveness aided leadership: Creation of leader in nursing profession is one of the biggest challenges, because strong leadership skills are required for all professionals and especially for those nurses who are dealing with direct care with the higher management. Leadership skill is not simply a bunch of tasks; it is the continuous performance on managing tasks. Style of leadership and theory of leadership has a difference (Gilliss, 2011). The reality is represented by theory and on the other hand style of leadership is the implementation of the theories in various possible ways (BLEGEN and SEVERINSSON, 2011). Required skills that are required to run a team day to day effectively is known as transactional leadership, where in transformational leadership the innovative approach in work gets ensured by an integrated teamwork. A good nurse should have these five attributes to become a good leader, like self-confidence, courage, active communication, growth and appreciation. Is a nurse ready to do whatever task he or she is assigned to do? Is she can give hundred percent to her work? Self-confidence can be assessed (Colwell, 2013). Is there is enough courage to take responsibilities and play a safe role or go through risky path for the accomplishment of duty? In career path is the individual is growing day by day or stuck in a consistent place? Is a nurse can express his or her thoughts clearly or she is lagging behind for negative communication?

Assertive communication: For an effective communication between nurse and patients as well as nurse with other staffs of the organization and management assertiveness is very much important and necessary, and it gives an escalation to the confidence of that professionals (Casey and Wallis, 2011). Assertiveness in communication can be learned in the time of education or training during the nurse’s undergraduate curriculum, which is duly influenced by the experienced professionals involved in teaching (Harley, 2014). Assertive communication is respectful and direct, by which an individual gets the best chance to express his message successfully. If aggressive and passive communication has done, a message has a chance to get lost from people because they will get busy to react on the delivery (Chen, 2011). The assertion can be used to communicate successfully with anyone in a team to avoid mistakes, resolve differences and focus issues. Assertion model for patient safety is followed by the nurses.

Figure 1: Area of communication for nurse

Source:  (Grimes, 2011, p-88)

Case scenario:

A 19-year-old boy Res was admitted to my ward with operated appendicitis and other medical conditions like vomiting and hay fever. Normal saline was going on. It was strictly explained to the patient and his relatives that nothing could be given for eating purpose as well as drinking purpose, not even a drop of water, however due to be a teenager the drowsiness was still there a long after the operation and he asked for water several times in a certain period and showed unnecessary body movement. Due to this the patients’ relative asked me to observe the situation and to act if required.

I supported the patient by a through observation, where I found the normal saline dispenser was dispensing the drop of liquid a little slow towards the patient. I assured the patient’s family member and called the attendant doctor and stated the situation and asked for further intervention.

According to the doctor, it could be happened because of the low dispensing rate of the saline fluid and might be a mistake of the last attending nurse. I reassured the patient’s family member that the situation was handled with care and chances of this kind of response are not going to meet.

I reported the whole event to the sister in charge and filled an IR1 (Incident report) form.

Reflection through Rolfe model:

Figure 2: Rolfe reflective model

Source : (Schoonover-Shoffner, 2011, pp- 123)

What?

When an overall analysis done it seems that the issue in the scenario is over the dispensing of the saline liquid for which it may arise the problem on the patient, as well as the patient just came from a unconscious state and still was in a drowsy condition it cannot be evaluated properly if the problem was seriously regarded to any medical condition or an effect of just recovering from unconscious state. However, an increase in the saline dispensing rate was done as told by the attending doctor and his comments on the mistake during the implementation of the saline to the patient.  In that situation, my role was to observe and check the problem associated to the patient and inform that to the doctor as I was the assigned person to take care of that patient (alayi, Khamen and AhmadiGatab, 2011). The problem was a technical mistake or a fault of the dispensing machine was unknown and required an investigation. Still as the problem raised and I have a professional duty to state about the mishap to Sister in charge, and after a brief discussion with her an incident report form was dully filled by me and latter the form was forwarded to the management of hospital for further proceedings. After a certain time of intense reflection, I realised that the action taken by me was right because I was on the role to advocate behalf of patient as well as my professional duty is to deliver the best for my patient.

So what?

There are lots of ethical considerations which can be encountered by a nurse in the workplace, which includes the comparison between quantity versus quality of life, between deception and truth telling, between personal belief and empirical knowledge. Professional nurses’ responsibility is to ensure that the highest quality of patient care should be delivered to a patients. After the analysis of this condition, reason is straight forward that there is a mishap in the delivery of therapy that was duly corrected at the time, but according to the nursing ethics patient care is the first and foremost thing to handle carefully and confidently. I did think about the option of speaking to the previous attendant of the patient unofficially but reached to the conclusion that there is no way to alter the actual course of action. This point of analysis availed me a deeper insight into the condition and strengthened my primary conclusions connecting to the appropriate and proper course of action.

Now, what?

As per the fact reported from the patients’ end, it was possibly subjected to a mishap in the delivery of the saline solution. The action taken by the sister in charge, by stabilising the rate of delivery of saline as per the attending physician’s direction, seemed proportionate and appropriate. My assurance to patients’ family member on the raised fact, that such kind of problem is not going to happen. As well as it also stated the matter that I was taking the situation and was sorry that the mishap took place. Reflection on the situation, collectively with the guidance got from the sister in charge, has facilitated me to completely understand the key elements of this condition. Further in future if I face such kind of complication again, more confidence will be there in me to handle or supervise the situation.

  Discussion:

Assertiveness is a manner towards me and others that is honest and helpful. In assertiveness I ask for what I want in an open and direct manner as well as in an appropriate manner respecting my personal opinion and rights. I can do work confidently and without anxiety. In assertiveness I should not violate a person’s right and should expect same kind of feedback from others but not in that scene like that they can know me magically.

References:

alayi, Z., Khamen, A. and AhmadiGatab, T. (2011). Parenting style and Self-Assertiveness: Effects of a Training Program on Self-Assertiveness of Iranian High School Girls. Procedia – Social and Behavioral Sciences, 30, pp.1945-1950.

BLEGEN, N. and SEVERINSSON, E. (2011). Leadership and management in mental health nursing. Journal of Nursing Management, 19(4), pp.487-497.

Casey, A. and Wallis, A. (2011). Effective communication: Principle of Nursing Practice E. Nursing Standard, 25(32), pp.35-37.

Chen, R. (2011). Moral imagination in simulation-based communication skills training. Nursing Ethics, 18(1), pp.102-111.

Colwell, G. (2013). An underrated leadership skill. Nursing Standard, 27(47), pp.63-63.

Cutright, M. (2011). Media Review: Assertion Achieving Success Through Academic Assertiveness: Real Life Strategies for Today’s Higher Education Students. Journal of Student Affairs Research and Practice, 48(1).

Gilliss, C. (2011). Developing policy leadership in nursing: Three wishes. Nursing Outlook, 59(4), pp.179-181.

Grimes, S. (2011). Improving Patient Care Through Communication. Journal of Radiology Nursing, 30(2), p.88.

Harley, J. (2014). Developing Assertiveness Skills for Health and Social Care Professionals Phillips Annie Developing Assertiveness Skills for Health and Social Care Professionals288pp £35 9781846199776 1846199778 Radcliffe. Nursing Management, 20(10), pp.17-17.

Ibrahim, S. (2011). Factors affecting assertiveness among student nurses. Nurse Education Today, 31(4), pp.356-360.

Kammrath, L., McCarthy, M., Cortes, K. and Friesen, C. (2015). Picking One’s Battles: How Assertiveness and Unassertiveness Abilities Are Associated With Extraversion and Agreeableness. Social Psychological and Personality Science, 6(6), pp.622-629.

Ockey, G. (2011). Self-consciousness and Assertiveness as Explanatory Variables of L2 Oral Ability: A Latent Variable Approach. Language Learning, 61(3), pp.968-989.

Powell, M. and Newgent, R. (2011). Assertiveness and Mental Health Professionals: Differences Between Insight-Oriented and Action-Oriented Clinician. TPC, 1(2), pp.92-98.

Schoonover-Shoffner, K. (2011). Reflections on Reflective Practice. Journal of Christian Nursing, 28(3), p.123.