Question:-

Analyse one or two challenges reported in literature that a new graduate nurse may face in their transition into the professional workplace.

Answer:-

My first clinical placement involved in providing nursing management and care to Mr X. He had certain procedures operationally causing him pain and discomfort. When helping with his breakfast he kept coughing so I contacted the RN informing this situation. She then arrived seeing Mr X, encouraging him in vomiting the food which he did, feeling comfortable. The RN mentioned in me staying with him for observing his condition changes. Though even after trying in making him feel comfortable I could watch him coughing at times. A few minutes later I see his breathing patterns being irregular. I contacted the RN immediately to which she arrived where Mr X couldn’t respond much. We let him lie down on the bed on the left side where the RN began in providing few abdominal thrusts and backslaps. Thus caused him in coughing again, regaining consciousness. Then the doctor arrived, taking Mr X under care management.

The RN there had wider experiences when handling this situation type acting on his situation immediately. When she arrived I took his vital signs immediately to provide the RN. The RN got all information through me advising me in handling this situation very calmly in professional means. I asked a few questions to him for getting any feedback positively with making sure of him being in his position comfortably. Both of us put Mr X back to his bed positioning on the left side for food removal from the mouth. She then made me check if anything else is left into his mouth. When analysing this scenario I experienced, the organization cluster here falls into the constructive kind which can be considered as a cluster. In this cluster, the members are provided with encouragement for interacting with others. This culture made me ask further questions to the patient for feedback. Also, the RN here encouraged me in handling the situation professionally, remaining calm. It involves approaching those tasks in means helping them in meeting their satisfaction needs of the higher-order. This constructive cluster consists of the achievement culture styling. This is where the members are expected upon setting realistic yet challenging goals. Then there is the self-actualization styling where these members keep having expectancies in work enjoyment. It involves developing themselves and taking interesting and new activities. Then there is the humanistic style where each member is expected upon becoming constructive ad supportive. Then lastly there is the style of affiliative culture. This is where the organization members are expected in becoming sensitive, cooperative and friendly towards group work satisfaction. Among all the culture clusters in this organization, the constructive one becomes effective highly, promoting organizational, group and individual performance. The diagnostic assessing of the organizational culture in nursing identifies the nurses’ weaknesses and strengths.

As a nurse, I feel that we keep playing that vital role in creating a safety culture with the area of clinical work. This occurs through maintaining communications with the members of the healthcare team. It involves assessing the self and peers’ work behaviours and habits professionally for risks of the safety. It involves utilizing the interventions of the EBP (evidence-based practise) in the patient protocol with participation in workgroups of shared governance. The culture of safety becomes essential in optimizing workplace satisfaction and patient outcomes (Kalteh et al., 2019). With colleagues the open communication help in addressing practice problems which keep impacting patient safety potentially. If I keep witnessing communication unprofessionally I would keep addressing that issue during the moment. Several peers of ours might become unaware of the ways their non-verbal and verbal communication gets processed and received through the other members in this healthcare team (Lee et al., 2019). If I do not feel comfortable in addressing the behaviours myself professionally I must escalate my concerns to my supervisor. Another way in attaining the safety culture involves taking part in workgroups of shared governance. Through active contribution to my unit’s committee of shared governance, I would keep identifying risks of the safety. I would also keep providing solutions to realistically (Cho, Heo & Moon, 2016).

Health informatics

As a nurse, I utilized the EMR (an electrical medical record) once in my placement during some urgency turning out its quite helpful in staying organized. It keeps providing better care management for the patients, providing better healthcare. This involves providing complete, up-to-date and accurate information regarding patients at the care point (Jawhari et al., 2016). I saw that involves reminders of medications, drug interaction prevention methods, clinical care documentation and patient medical history. When using the device I noticed that it is really helpful I providing billing and coding streamlined. Most importantly, it reduces costs through improving health, testing duplication reduced, improved safety and decreased paperwork (Dong et al., 2016).

During my nursing experiences in the placement, I saw that the EMR is not maintained properly. There was an issue with the machine to start at times also the information is not appearing properly when required urgently. It seems that the EMR is one costly investment requiring a lot of maintenance if used a lot. This is the reason many hospitals are there not utilizing EMR. Those financial problems involve the implementation and adoption cost, revenue declines, revenue loss having an association with productivity loss temporarily. They keep presenting this disincentive for physicians and hospitals in implanting and adopting the EMR (Wu et al., 2017). The implementation and adoption costs involve installing and purchasing software and hardware, conversion from paper to electronic charts and end-user training. Several studies kept documenting upon those costs within both the outpatients and inpatient setting. One study involved the conduction of the acute care hospital beds of 280. The total projected cost for the HER installation project for long becomes US$19 million approximately. Within this outpatient setting, the early researchers kept estimating the initial cost of 50,000-70,000 US dollars on average (Basjaruddin, Rakhman & Renardi, 2017). This occurred for per physician for the office has 3 physicians. The EMR technologies, however, became that commonplace since the last decade with the system initial cost keeps dramatically coming down. This industry group kept estimating telecommunications, services, software and hardware costing being US$ 14,000 per physician approximately. The EMR maintenance cost becomes costly as well where the hardware requires in replacing with software upgrading on the daily basis. Additionally, the providers require in having ongoing support and training for the EMR end-users (Enaizan et al., 2020). The EMR cost ongoing maintenance, implementation and adoption get compounding to this fact where several EMR benefits financially would not keep accruing this provider generally. This involves rather the third-party payers in having error forms improved and averted efficiencies. These keep translating into claim payments reduced. The incentive misalignment for those healthcare organizations with upfront costs highly makes one barrier for HER implementation and adoption. Also, those physicians keep citing upfront costs frequently with maintenance cost ongoing (Kini et al., 2020). This becomes this huge barrier for implementation and adoption of the EMR.

As the registered nurse, the role in utilizing the EMR, in general, involves recording and reviewing patient information electronically. It involves meaning and organizing data for databases clinically along with assessing and analysing the patient outcome. This provides patient health information securely for confidentiality. This is where the ethnic utilization of this EMR arrives for the nursing role. The patient information requires releasing others with allowing the law or the patient’s information only. The patient cannot do such due to mental incapacity and age. This occurs regarding the information share requires in creating by the patient’s legal guardian or representative (Kajimura et al., 2016). The information-sharing occurs due to interactions clinically getting the consideration as confidential requiring protection. This information from where the patient identity could not get assertion for instance. This is where the patient numbers having breast carcinoma is the hospital (governmental) is not within this category. The insurance companies, healthcare institutions and others require data access if these EMRs cannot get designed in functioning. This key in confidentiality preservation involves allowing the authorized individuals only for having information access. This starts with user authorization. The access of the user has a basis upon the privileges which are role-based and pre-established.

Transition to practice

When transitioning into the workplace professionally, the new graduate nurses keep facing several challenges which will be discussed. The first one involves workload where several studies revealed upon the participants as nurses experienced heavily. They keep mentioning upon heavier workload involving paperwork in lots with multiple task management simultaneously. These involve giving treatments after this doctor keeps completing warding rounds along with answering patient and relative enquiries. It also involves giving guidance to those student nurses with monitoring of dangerous drugs frequently. The heavy workload with insufficient resources and manpower keeps increasing the stress levels further. One of those participants is this rehabilitation hospital got needs in completing every task within the office timings. The tasks involved sending specimens due to supporting departments remaining open till 5 pm in weekdays only (Ayanlade, 2018). With workload provided heavily, the kept lacking time in communicating with the relatives and patients which causes misunderstandings and conflicts further. Another important challenge for new nurses involves the participants expressing difficulties in communication with parties differently. But the difficult aspect at most involves dealings with the relatives and participants. This occurred since those expectations became higher compared to what they can give resulting in easy conflicts. The medical term translations into layman forms through clear and simple presentation becomes one challenging task for those participants. They kept encountering difficulties in understanding of these doctor handwritings in the records of treatment. Still, they showed fear in clarifying this with those doctors due to poorer skills in call handling. The participants preferred communications face-to-face with health colleagues allied. This occurred rather than reading the notes in progress records merely due to them wanting in understanding the patient progress. These participants kept engaging in communications relaxed with those junior colleagues. They required in watching those attitudes while speaking to those senior colleagues for avoiding ridicule.

For positive workplace attitudes or behaviours for any nurse one involves respecting and helping others. The ones having self-respect cannot do manager biding where they keep thinking for themselves with presenting ideas alternatively at times. The staff requires having those respectful attitudes during client interaction with co-workers and customers too. With this, having one helpful attitude helps in accomplishing the organization’s goals overall. This might involve assisting the customers and clients with helping the staff. The more the employees have this helpful attitude, further the others would have willingness in partnering with the employees on main initiatives and projects.  The other attitude or behaviour involves finding new ideas/innovations with enthusiasm (Kajimura et al., 2016). Those nurses having the attitude of innovation would not keep shying away when going for something new. This also involves finding different means of doing activities. The small organizations require employees able to keep thinking outside that box forming ways of innovation. This occurs for approaching goals and accomplishing existing tasks. The nurse having this attitude type keep knowing those ideas not working out much for doing the best in something. Still, the big failure is not becoming less when providing new ideas with the chance. The enthusiasm towards life helps in formulating new ideas. The first self-care strategy for nurses involves physical means. Maintaining hydration becomes one challenge for the nurse thus for combating that, taking sips of ti during the shift helps. When becoming busy among the patients this might become easier in overlooking one’s needs. Thus, providing time for breaks of restroom during this shift becomes significant. Some trips to the restroom for 2 minutes keep preventing painful and unnecessary bladder and urinary tract infections. As that nurse, one might encounter burning via calories getting faster than the thought of. Thus having healthy snacks and meals are considered when available. Sugar and caffeine foods are avoided.   The second strategy for the nurse involves mental and social needs. The techniques of meditation like guided imagery and deep breathing might become instrumental for refocusing on the present and relieving stress (Enaizan et al., 2020). The on-call assignments and shift work would keep wreaking havoc on one’s life personally. Though it becomes much tempting in passing the family and friend outings, maintaining those relations helps a lot. This keeps improving health emotionally. Even when not working in night shifting, forming one sleep environment relaxed keeps ensuring upon getting the rest needed. Noise machines and earplugs, eye masks and room-darkening curtains are helpful.

References

Ayanlade, O. S. (2018). Electronic Medical Record System as a central ICT tool for quality healthcare services: Nigeria as a case study. African Journal of Science, Technology, Innovation and Development, 10(2), 147-157.

Basjaruddin, N. C., Rakhman, E., & Renardi, M. B. (2017, December). Developing Electronic Medical Record Based on NFC. In Proceedings of the 2017 International Conference on Computer Science and Artificial Intelligence (pp. 148-152).

Cho, S. D., Heo, S. E., & Moon, D. H. (2016). A convergence study on the hospital nurse’s perception of patient safety culture and safety nursing activity. Journal of the Korea Convergence Society, 7(1), 125-136.

Dong, X., Qian, L., Guan, Y., Huang, L., Yu, Q., & Yang, J. (2016, August). A multiclass classification method based on deep learning for named entity recognition in electronic medical records. In 2016 New York Scientific Data Summit (NYSDS) (pp. 1-10). IEEE.

Enaizan, O., Zaidan, A. A., Alwi, N. M., Zaidan, B. B., Alsalem, M. A., Albahri, O. S., & Albahri, A. S. (2020). Electronic medical record systems: Decision support examination framework for individual, security and privacy concerns using multi-perspective analysis. Health and Technology, 10(3), 795-822.

Jawhari, B., Keenan, L., Zakus, D., Ludwick, D., Isaac, A., Saleh, A., & Hayward, R. (2016). Barriers and facilitators to Electronic Medical Record (EMR) use in an urban slum. International journal of medical informatics, 94, 246-254.

Kajimura, A., Takemura, T., Hikita, T., Fujita, K., Yoshihara, W., Hashiya, A., & Kuroda, T. (2016). Nurses’ Actual Usage of EMRs: An Access Log-Based Analysis. In Nursing Informatics (pp. 858-859).

Kalteh, H. O., Mortazavi, S. B., Mohammadi, E., & Salesi, M. (2019). The relationship between safety culture and safety climate and safety performance: a systematic review. International journal of occupational safety and ergonomics, 1-11.

Kini, U. A., Bhat, M. P., Ganiga, R., Pai, R. M., Pai, M. M., & Prasad, H. S. (2020). Detection and Control of Phishing Attack in Electronic Medical Record Application. In Advances in Electrical and Computer Technologies (pp. 975-985). Springer, Singapore.

Lee, S. E., Scott, L. D., Dahinten, V. S., Vincent, C., Lopez, K. D., & Park, C. G. (2019). Safety culture, patient safety, and quality of care outcomes: A literature review. Western journal of nursing research, 41(2), 279-304.

Wu, C. H., Chiu, R. K., & Yeh, H. M. (2017). Implementation of a cloud-based electronic medical record exchange system in compliance with the integrating healthcare enterprise’s cross-enterprise document sharing integration profile. International journal of medical informatics, 107, 30-39.