Debbie and Bonnie's last minute notes of review
N9 Final Review
These notes have been moved to the comments to reduce the bogging down of the blog scrolling.
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Welcome to the original SJDC nursing student blog. This is the place where we all can learn together, after all, more heads are better than one. Come on in, share, laugh and learn. Together we will all succeed!
Nursing Associations and CEUs
- American Nurses Association
- American Association of Critical Care Nurses
- Emergency Nurses Association
- Society of Pediatric Nurses
- American Psychiatric Nurses Association
- California Board of Registered Nursing
- All State Nursing Boards
- California Nursing Students Association
- National Student Nurses' Association
- Medscape Free CEUs
- Nursing Center CEUs
- Wild Iris Nursing CEUs
- CEU Professor
- Swank Health Care
Practice Tests and Quizzes
- Original Test Bank
- NCLEX Review 3500
- ATI Testing Site with our Semester Codes
- Drug Calculation Quizzes
- Cranial Nerves Practice Quiz
- Autonomic Nervous System Pharmacology Quiz
- Hemodynamic Measurements and mini quiz
- Cardiac Trivia Challenge 1
- Cardiac Trivia Challenge 2 (harder)
- ACLS Practice Simulator
- EKG Practice Simulator and Quiz
- EKG Parameter Quiz
- STEMI Practice Quiz
- ABG Practice Quiz
- ABG Tutorial and case study questions
- Shock Study Table and Quiz
- Immunology Interactive Quiz
- Question of the Week
- Study Stack For Nursing - Interactive
- Pediatric Practice Quizzes
Helpful Links
- Critical Care Tutorials
- Merck Manual - Critical Care Medicine
- Critical Care Nursing - Medscape
- Ventilator Modes
- Pharmacology Links
- Medical Learning Links
- Nursing 101
- Citation Builder (for scholarly paper writing)
- AACN PDA Info and Software
- EVOLVE TEXTBOOKS
- Interactive Quizzes, Games and Flashcards
- Nursing Internet Learning Resources
- Student Nurse Journey
- Fern's Blog
2 comments:
Take care of yourself, at home and at work. Stress leads to a focus on efficiency, rather than on effectiveness. Efficiency is doing many things right, effectiveness is doing the right thing. Focus on effectiveness by taking care of yourself first; then you will have more to give to your patients.
Chapter 19 Building Teams Through Communication and Partnerships
Teams/Groups-what are the differences and similarities?
Team vs. groups-Concepts of each
Team: a number of persons work on defined objective in ongoing relationship that are supportive and focused on task.
Group: A number of people of persons gathered with no goals or objective in common
Behaviors-compare and contrast
Philosophy or goal with objectives as team
As team working with:
Dietician/dietary
Housekeeping
PT
OT
MDs
RN
Pharmacy
Each team member has a contribution to make-it is valuable.
Teams have going for them-
Motivations
Goals
Team not working: what do you see?
Teams essential in providing: high quality and cost effective health care.
Team members pick up slack for each other
Take care of your pt when you are gone.
Have: clearly defined goals
Creative problem solving
To define goals
To develop solutions
Mutual respect and support of each other
What is communication like?
Have level of understanding of team members: strengths and weakness
Willing to learn, listen and share
Disagreements-how handled:
Consensus-professionals agree
Information given to people- how given?
Ineffective Team - dominated by a few who run the show
Pick your battles
Autocratic and rigid leadership makes for ineffective teams.
Communication formal and rigid
Criticism is often destructive, ineffective, and hurtful.
Internalize feelings of resentment
Teams:
Clarity of purpose
Informal-friends and trust/respect
Congeniality (friends) support
Committed
Increased level of participation
Listen with respect
Communicate openly
Consensus
Roles/assignments are clear
Share leadership roles and recognize each others strengths/weaknesses.
The only thing that humans do more than communicate is breathe!
Patterns of communication:
Therapeutic
What interferes with good communication?
Communication barriers
Distractions
Inadequate knowledge
Poor planning
Differences in perception
Emotions and personality (stress/distress)
Effective communication
Trust
Clear language and instructions
Encourage viewpoints/feeling
TEST-conflict resolution
What is it and how resolve?
Active listening
What is it? Focusing completely on the speaker and listening without judgment to the essence of the conversation; and active listener should be able to repeat at lest accurately 95% of the speakers intended meaning.
Why use it?
Descriptors:
Behaviors we can use to indicate active listening
Pros and cons
Chapter 20 Conflict: The Cutting Edge of Change
Conflict: A perceived difference among people and a four-stage process including frustration, conceptualization, action, and outcomes.
Group conflict -
Intrapersonal conflict – within a person Know differences
Interpersonal conflict – between people
Organizational conflict - policies and procedures, hierarchical structure and role differentiation, cost reduction and quality of care
How does conflict work, how do you resolve it.
Who resolves and how
What are stages of conflict?
1. Frustration- This happens when people or groups perceive that their goals may be blocked. P352 Frustration comes from what people believe to be true.
2. Conceptualization- Forms the basis for everyone’s reaction to frustration. It is an individual’s interpretation of what the conflict is and why it is occurring. It is based on personal values, beliefs and culture.
3. Action- Intentions, strategies, plans and behavior. Some action toward the conflict will always be taken, even if it is avoidance.
5 action oriented approaches –
1. avoiding
2. accommodating,
3. competing,
4. compromising
5. collaborating.
4. Outcomes- Tangible and in tangible consequences or outcomes result from the actions taken.
Chapter 21
Delegation-what is it?
Book definition: consists of two people
Transition of authority
In work context
Abdication of responsibility—NO
Need to be accountable for delegated authority
Be clear-your are responsible for outcomes, legal responsibility
Who can you delegate to?
RN-responsibility
Qualified Delegatee - Accountability
Anyone else-you are responsible to make sure that task is done
1. Certain that delegation is to person with proper qualifications
2. All staff is properly identified.
3. Make sure proper directions for job are given, give parameters
4. Follow through
Negative:
Not give proper directions, no parameters, no follow through
3 things that CAN’T be delegated:
1. Initial and subsequent nursing assessments that require professional judgment.
2. Determination of nursing diagnosis
Goals
Care plans
Progress/evaluation
3. Interventions that require professional knowledge and skill
Legal parameters to delegating
Watch out for –
1. Potential for harm – pt stable?
2. Complexity of task
3. Need for problem solving and innovation
4. Unpredictability of the outcome
5. Level of interaction with the pt
Roles-what the can and cannot do.
LVNs can assess problems that have been identified by RN.
Can’t ID new problems
Can’t write care plan
Can’t do admission assessments
RN should assess pt at least once during shift and check charting and sign off or make note and sign off.
Advantages of delegation
Best-giving a task you are saying I trust your judgment, your skill level. Note of confidence and trust between co-workers.
Gives: feeling of control
Skills
Accountability
Thank them, “return favor”, be real
Difference:
Accountability – The expectation of explaining actions and results. Pg372
Responsibility – The condition of being reliable and dependable and being obligated to accomplish work. pg372
Assignment – transfers both responsibility and accountability. RN to RN
Who has which and what are they? The delegatee has the accountability and the delagator has the responsibility.
Chapter 24 Self-Management: Stress and Time
Time Management
How to assess self and manage time and stress
How to recognize the symptoms of stress.
Recognize stressors and stop cycle?
Primary Prevention – determine and eliminate its source
Eliminate the stressor, modify the stressor, and change perceptions of the stressor
Secondary Prevention – Positive social support, strong belief system, sense of humor, exercise and relaxation
Emotional symptoms – anxiety, depression and anger - meditation, prayer, counseling, support groups, networking, communicate feelings, get a mentor, ask for feedback and clarification
Physical symptoms – fatigue, headache, insomnia – accept limitations, modify nutrition, exercise, make physical health a priority, nurture yourself, sleep, relax
Mental changes – decreased concentration, and memory – say no, self-talk, imagery, hobbies, vacation, learn to handle problems, learn communication and conflict resolution, time management, take CEUs
Behavioral changes – smoking, drinking, crying and swearing
Tertiary Prevention – Refocus
Burnout – Prolonged response to chronic emotional and interpersonal stressors on the job
Characteristics of burnout –
1. a feeling of emotional exhaustion
2. depersonalization or cynicism
3. a decreased sense of effectiveness
Who is your stressor?
Personal, to me, management steps.
What are they?
What are strategies for stress management?
Time Wasters – Too much work, Inability to say no, procrastination, complaining, perfectionism, interruptions, disorganization, too much information
Chapter 25
Power - The ability to influence others in the effort to achieve goals
Social Power – Power-what are levels of political activism. How do you use them?
1. Coercive Power – based on fear and the power to punish - has negative connotations. Not always used negatively
2. Reward Power – based on the ability to grant rewards and favors
3. Expert power – Results from the knowledge and skills one possesses that are needed by others - Patricia Benner “Novice to Expert”
4. Legitimate Power – Possessed by virtue of one’s position within an organization or status within a group
5. Referent Power – Results from followers desire to identify with a powerful person – who is out there reading journals and doing research
6. Information Power – Stems from ones possession of selected information that is needed by others.
7. Connection Power – Gained by association with people who are perceived as powerful.
What power do nurses have?
People listen to what you have to say.
Feeling of control- can be a good thing or negative.
How do we get power as a profession?
License – A right granted the licensee permission to do something not legally done without such permission. Also the minimum form of credentialing, providing baseline expectations for those in a particular field without identifying or obligating the practitioner to function in a professional manner as defined by the profession itself.
Standards of Practice at work
What do they allow you to do?
What about in the State of California?
CA Nurse Practice Acts
CNA-who gives them power? (union)
ANA and ANA/C-how do they speak for RNs, who gives them the power?
As a group how do we get power, use it, where do we use it and for what?
Nursing-largest professional work force in the U.S.
How does political activism work?
Nurse managers
Behavior that they use
Framing public policy.
How and why should nurses be involved in shaping public policy?
Chapter 26 Career Management
Where are you going, what styles?
1. Steady State – Staff nurses - constancy
2. Linear – Nursing service administrator – hierarchical orientation
3. Entrepreneurial and transient – Nurses in private practice, temp assignments
4. Spiral – Retuning Nurses to the workforce after family raising
Certifications’-why do it? – It recognizes the competence of the nurse in a specialized field.
What does that public think about certs for RNs? Credibility, increased confidence
Why get them?
Resumes—CV
Curriculum Vitae (VeeTie)
An all inclusive but not detailed listing of professional life activities. Just the facts.
Resume’
A detailed customized document that sells the individual for the specific position being sought. 1 or 2 pages are acceptable. More than just the facts. Reflects experiences and accomplishments.
What parts?
What purpose
Personal data file
Chapter 27 Leading through Professional Nursing Associations
What is the purpose of professional RN organization?
1. Promote the economic and general welfare of nurses in the workplace,
2. projecting a positive and realistic view of nursing,
3. lobbying congress and regulatory agencies on healthcare issues affecting nurses and the public.
What advantage? –
1. Discounts on CEUs,
2. Certification,
3. Credentialing,
4. Group insurance plans,
5. Travel services,
6. Access to staff expert’s legal legislative and edu issues,
7. Professional standards,
8. discounts on journals
Who does it serve? (RN professional organization)
Belonging to a professional association not only demonstrates professional leadership but also provides numerous opportunities to meet other leaders, participate in policy formation, continue specialized education and shape the future of the profession.
Who loyal to? (Dues paying members)
What purpose in nursing?
Benefits of – networking and exposure to different opportunities within the nursing profession
Many offer substantial scholarships for nurses who are perusing higher education and certifications.
Shared governance – A term used to describe a flat type of organizational structure with a decision making decentralized. The governance is shared by those who are directly involved.
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