Roxana Zavala
Objective 5
Patient Care Models
In the organization where I have worked since 2008, we use the functional method. We have a Charge Nurse, who, on the weekdays, is the Director of Nurses (DON). On the weekends, the nurse in charge of the shift becomes the Charge Nurse for that shift. Our facility is meant for short-term stays: no more than 90 days. There are only 16 bed available. Patients are admitted in order to obtain an optimal rehabilitation and later be able to be discharged home or be transferred to a long term facility. In some cases, patients are sent to hospice agencies for the end-of-life process. The Charge Nurses assess, plan, implement, coordinate, monitor, and evaluate patient health care plans. The RN on duty monitors medications, assesses, plans, implements care and evaluates care outcomes. The RN is also in charge of performing all the wound care and treatments. We also have three certified nurses assistance (CNA) when the establishment is full and two CNA when the census goes down to ten patients. CNA provide functional roles like toileting, bathing, bed-making and fulfill clerical and housekeeping roles as well. I noticed that this method is very common in the state of Utah, and works very well in my work place, because it allows us to focus on our duties. Of course, all the employees work as a team in all aspects of patient care. Our CNAs never get burnt out, because we motivate them with gift cards, thank you cards and words of encouragement and appreciation.
Different Types of Power
- Reward power: When the person is able to grant favors or reward others. This type of power among leadership brings optimal results in loyalty.
- Coercive power: My least favorite kind of power, because it uses fear of punishments like transfers, layoffs or dismissal if goals are not met.
- Evert power: Obtained through knowledge and experience. This kind of power is limited to a specialized area.
- Referent power: Power that managers or leaders have because they possess charisma and others see them as model leaders.
Objective #6
Attitude toward change
In my life I have been through a lot of changes and I don’t regret any because each has served an opportunity for me to be challenged and adapt myself to new situations and circumstances. But it is also true that the older one gets, the more resilient one is to accept change. I am always open to new opportunities that can help me to grow in all aspects of my life. For example, my family is getting ready to face a big change: I live with my mother and nice and am also the main provider for my family. I had decided that we should move to California or Arizona, but my family disagrees with this big change. My mom has gotten used to living here and my little niece likes her friends and teacher. I explained each of them all the benefits of the change and after two long months of talk they are still undecided. I will give them time to process the change. In April we are going to Arizona for a week and staying at my niece's house, and in May we are going to California for two weeks and staying in my brother's house. After this, we will make the final decision. If they accept the change, I will be very supportive in their emotional needs and hopefully all of us can be happy.
Objective #8
Career Development Plan
For my future in the nursing profession, I want to make a reality out of my career development plan. I’m glad I was exposed to this chapter; it helped me a lot to broaden my view on the development of an effective career plan. I will use these steps I found in the book as an outline. ( Marquis.B&Huston, C.,2009)
- I will assess my interest, skills, strengths and values by deciding what I am going to do for the rest of my nursing career, in order to grow personally and be able to help my family.
- Determination of Goals: at the moment my goal is to move to a bigger state, where I can pursuit my PhD in education. For three years I have been teaching the CAN; now I want to teach the nursing students.
- Assess the Organization for Opportunities: in my mind, there are two universities were I want to go: AZU in Arizona or UCLA in California. I going to apply to both of them and do whatever it takes to get there.
- Develop Strategies: My strategies are applying to those schools and be able to meet their requirements for the institutions.
- Implement Plans: once I am accepted to one of these schools, I will prepare my family for the final move.
- Evaluate plans: I will evaluate what state offers more security and is the most cost effective in order to make the final decision.
- Reassess and Make New Plans as Necessary, at Least Biannually: in the worst case scenario, if I don’t get accepted to any of those schools I will self-assess my other interests.
Objective #9
Motivation
“How we feel about and enjoy our work is crucial to how we perceive the quality of our lives.” —Jo Manion
For me, motivation is an inner force that inspires all people to do great things, to make the impossible possible. Motivation is necessary in order to accomplish a task. Motivation, for me, is positive energy that is between your mind and your soul; it is a deep and powerful source that all humans have in order to succeed in this life.
I remember when I worked at the University of Utah Hospital. Each week my manager gave me a gift card that was worth five dollars to reward me for my hard work at my shift. I collected more than 50 gift cards. For me, this reward was a big motivator to keep working in the unit. I totally appreciated that my manager recognized my dedication to my patients and my hard work. As a matter of fact, I have kept some of these cards as physical reminders of those great times. I have received other awards from my managers, but those U of U gift cards gave me a sense of accomplishment as a nurse, especially because at the time I was a brand new nurse. I am still working in this profession; this year is going to be my seventh year as a nurse, thanks to those cards that my dear manager gave me.
Objective #10
Managing Conflict
I remember a time when I was a new RN and was overwhelmed information I needed to process and master. I had a conflict with an experienced RN; she had noticed my lack of skills and was not tolerant whatsoever of my situation. Every time we had to work together, she started to make negative comments about my performance as a nurse. It got to the point that I could not tolerate her anymore, so I decided to stand up for myself by working harder, reading my protocols, attending all the nursing seminars, subscribing to nursing magazines and going to an online university to get updated information. After a few months, we were in the lunch room together and she made a positive comment about my performance. She said I was very persistent in my attempts to succeed as a nurse, and that she had underestimated my nursing capabilities. I also remember talking to my manager about this situation in one of the meetings. She encouraged the old nurses to be more supportive to the new nurses by coaching, doing mentoring, and avoiding destructive comment aimed at the new employees. This manager stood by my side in those difficult moments. Her actions showed me that she was clearly validating my efforts to succeed as a nurse.
The way my manager handled this situation is how I want to handle a case when new nurses have to deal with intolerant coworkers. The first thing I will do is talk to the intolerant nurse and remind her of when she was new in the profession and what motivated her to stay in the nursing field. Secondly, I would encouraged her to be a mentor to the new nurses, since she is considered one of the best experienced and skillful nurses in the unit. I would remind the experienced nurse of the importance and value in managing diversity in the health arena.
