NURS FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification NR

Interview Summary

NURS FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification NR

For this assignment, I decided to interview my current supervisor at Lee Health, Tara Woodring. Tara has been the night supervisor for the emergency department (ED) at Lee Memorial Hospital for the past five years and is well-versed in the issues we face and how to best deal with them. At present, our ED is overwhelmed with the sheer number of Covid patients coming in through the front door and via emergency medical services (EMS). 

Before the current pandemic, the ED employed a system that seamlessly saw patients in and out in under three hours during peak season. Currently, some patients are waiting to be seen for over nine hours which is three times longer than the usual peak wait times. This delay leads to patient dissatisfaction, missed diagnoses in triage, and burnout amongst nurses that feel underappreciated by an angry patient population.

NURS FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification NR

Tara states that the issue is due to the current rise in patient numbers and a loss of nurses that have quit either due to burnout or to pursue more lucrative opportunities such as travel nursing. Additionally, Lee Memorial Hospital has been hit even harder due to the relocation of our trauma center to Gulf Coast Medical Center (GCMC), another Lee Health hospital 15 miles away. This move has cost us even more nurses since many have moved to GCMC.

Tara is a strong advocate for interdisciplinary collaboration as she believes it is the only way to hold a system under such stress from falling apart. She has been meeting diligently with other supervisors and directors across the hospital to determine areas in which collaboration can reduce the current ED burden. Her biggest concern is patient safety issues such as missed or wrong medication doses, missed diagnoses, and hatred amongst staff nurses and travelers.

Issue Identification

My takeaway from my interview is that the main issue facing our ED is patient safety due to the loss of adequately trained nurses and a rise in the patient population. This overload stresses already burned-out nurses leading to increased errors in care and poor morale overall. According to a cross-sectional study, “effective measures are necessary to preserve the mental health of nurses in emergency departments and fever clinics. These include strengthening protective training, reducing night shifts, ensuring adequate rest time, and timely updating the latest pandemic situation” (Cui, S. et al. 2021). 

NURS FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification NR

Interdisciplinary collaboration becomes a necessity to make such measures a reality. There will need to be seasonal staff available to reduce the burden on current staff, other support systems in place during shifts to ensure nurses can take adequate physical and mental breaks, and on-call therapists that nurses can speak with regarding their mental strain. Combining these can mitigate nursing staff turnover and reduce preventable errors in care. According to an article in the Journal of Nursing Care Quality, “communication between interdisciplinary team members and the effective coordination of the patient’s care plan are vital high-quality, safe care” (Malec et al., 2018).

Change Theories That Could Lead to an Interdisciplinary Solution

When looking at change theories that could work well in our ED, it was important that the theory was explicitly developed for nursing and could be used quickly and repeatedly with ease. After carefully researching multiple approaches, I decided to go with Lewin’s change theory. “Lewin’s Three-Step Model Change Management is highlighted throughout the nursing literature as a framework to transform care at the bedside” (Wojciechowski, E. et al. 2016). This theory’s three steps consist of unfreeze, change, and refreeze.

NURS FPX 4010 Assessment 2 Interview and Interdisciplinary Issue Identification NR

The unfreeze stage is the first step during which the organization determines what needs to be changed. During this phase, leadership support is gained, and time is taken to ensure that all employees are ready for the changes. Then comes the second step, which is the change itself. Staff must be involved during this process, and management must empower action. Additionally, communication is critical during this stage to ensure interdisciplinary collaboration. During the third and final step, refreezing, the changes are anchored into the culture. Continued support and training are provided to educate and sustain the newly implemented changes.

Leadership Strategies That Could Lead to an Interdisciplinary Solution

The best leadership strategy to carry out this change, in my opinion, is transformational leadership. Transformational leadership garners involvement from all levels rather than a top-down approach where ideas are passed down from upper management without any staff input. Transformational leadership is applied to nursing through four components. “These are idealized influence; inspirational motivation; intellectual stimulation; and individual consideration” (Collins, E. et al. 2020). This leadership strategy calls for leadership and accountability on all levels, which creates an atmosphere of collaboration between various team members in solving shared issues.

Collaboration Approaches for Interdisciplinary Teams

In light of the issues outlined by Tara during our interview, it is clear that a team-based approach where interdisciplinary collaboration takes place is the key to success at our ED. Based on this, I believe that the team nursing model is best suited for the needs of our unit. Across the various departments of our hospital, there are nurses with varying skills and expertise in different areas. Having the ability to pull from each of these invaluable experiences will provide our ED with the necessary coverage that we need. Currently, there is an independent mindset and approach to how everyone is working.

Using a team nursing model will advocate collaboration across disciplines, resulting in a more considerable skillset overall, which is needed to combat this pandemic overload. “The team nursing method aims to decentralize responsibilities, fighting against the traditional notion of nursing leadership and management concentrated on a single individual. Thus, each nurse recognizes the patients assigned to their team, contributing individually to the satisfaction of their needs” (Collins, E. et al., 2021). This approach will help streamline the care process, encourage collaboration amongst different disciplines, and ultimately see that the patient receives safer and better care.

References

Cui, S., Jiang, Y., Shi, Q., Zhang, L., Kong, D., Qian, M., & Chu, J. (2021). Impact of COVID-19 on Anxiety, Stress, and Coping Styles in Nurses in Emergency Departments and Fever Clinics: A Cross-Sectional Survey. Risk management and healthcare policy14, 585–594. https://doi.org/10.2147/RMHP.S289782 

Malec, Ann DNP, RN, ACNP, NEA-BC; Mørk, Anne MS, MHCDS, RN; Hoffman, Robert MD; Carlson, Elizabeth Ph.D., RN The Care Team Visit, Journal of Nursing Care Quality: April/June 2018 – Volume 33 – Issue 2 – p 135-142 DOI: 10.1097/NCQ.0000000000000279

Wojciechowski, E., Murphy, P., Pearsall, T., French, E., (May 31, 2016) “A Case Review: Integrating Lewin’s Theory with Lean’s System Approach for Change” OJIN: The Online Journal of Issues in Nursing Vol. 21 No. 2, Manuscript 4.

DOI: 10.3912/OJIN.Vol21No02Man04 https://doi.org/10.3912/OJIN.Vol21No02Man04

Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nursing standard (Royal College of Nursing (Great Britain): 1987)35(5), 59–66. https://doi.org/10.7748/ns.2019.e11408 

Parreira, P., Santos-Costa, P., Neri, M., Marques, A., Queirós, P., & Salgueiro-Oliveira, A. (2021). Work Methods for Nursing Care Delivery. International journal of environmental research and public health, 18(4), 2088. https://doi.org/10.3390/ijerph18042088

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