Intro. Ch. 24

Define Organizational Skills

A skill that requires planning and prioritizing, novice nurses have a hard time being organized because they may feel overwhelmed by the new environment. The use of a report sheet can enable the novice nurse to note important information received during the shift, to avoid forgetting.

*A novice nurse is having a hard time with time management. She notices all the other nurses are done before her. She is tired of having to review medications before she administers it. She comes to the conclusion that she no longer needs to review this and starts to medicate her patients without knowing all her medications. She is getting done quicker by doing this. What reality stage is she experiencing?

Shock (rejection) phase/Native because she the nurse is mimicking other nurses and taking shortcuts to finish fast even if the nurse does not know the action or side effect of the medication.

What is Socialism & how does it benefit a novice nurse?

Socialization and caring relationship with colleagues are key to a nurse's ability to transition or to just "survive" at the clinical level.

Protege

The benefactor(supporter) of mentoring

What is Biculturalism?

The joining of two contradictory value systems, those of school values with those of the workplace.

*How does a novice nurse benefit from a mentor?

The mentor will help the novice nurse recognize their weaknesses, strengths, set realistic goals by reinforcing and recommending appropriate courses of action, provide emotional support, and help them develop confidence and organizational skills, and to validate intuitive notions

What nurses are more prone to get burned out?

The more intelligent, hard-working nurses are the most prone to burnout.

The nurse is walking inside the patient's room and notices the patient is pacing and rubbing their hands and mumbling. What can this indicate?

Violence

Type 1 Workplace Violence

Violence by a stranger with criminal intent. These violent acts are not committed by employees; rather criminals are strangers without relationship to organization or employees. Robbery most common motive.

Type 2 Workplace Violence

Violence by customer or client. Patients or customers become perpetrators of violent acts.

Type 4 Workplace Violence

Violence by someone in a personal relationship. Individuals who have a current employee commit a violent act in the health care environment.

Shock (rejection) Phase

Orientation is over and the nurse receives daily assignments and begins the tasks. The nurse comes into contact with conflicting viewpoints and different ways of performing skills, but lack the security. Nurses feel alone, frightened, uncomfortable, lack of accomplishment, or react by isolating themselves.

*A novice nurse is unaware how to recognize workplace violence. The novice nurse mentor states to remember the acronym STAMPEDAR. What does this stand for?

S= staring, T= tone of voice, A= anxiety, M= mumbling, P= Pacing, E= emotions, D= disease process, A= assertive/nonassertive behavior, R= resources

What is the acronym used to define violence in the workplace?

STAMPEDAR, it is used as a guide to assess the risk of workplace violence.

*A novice nurse is not sure if she made the right decision in becoming a nurse. She tells her family it is nothing like nursing school or what I was taught. What phase is she in? How can she stop feeling this way?

Shock (Rejection) Phase: (runaway) the nurse must ask herself/himself, what must I do to become the kind of nurse I want to be? What must I do so that my nursing contributes to humankind and society?

*A novice nurse is reading the policies regarding chest tube dressing changes. The nurse walks in the patient room and realizes she has not retained the information required to effectively change the dressing. What reality phase is she experiencing?

Shock (rejection) Phase: after orientation is over and the nurse receives daily assignments and they are on their own, feeling alone. They come into contact with conflict viewpoints and different ways of performing skills.

What is a rutter nurse

A nurse with the attitude that "ill just do what I have to do to get by." They consider nursing just a job.

An example of what a nurse would say in the recovery phase?

"Ill hang that blood, and I'll bet I can infuse it before 8 hours this time."

Phases of Reality Shock

-Honeymoon Phase -Shock (rejection) Phase -Recovery Phase -Resolution Phase

Special needs of novice nurses

-Interpersonal skills and communication skills -Organizational skills -Delegation skills -Priority-setting skills -Assertiveness skills -Dealing with horizontal violence -Intuition

What is the difference between evaluation methods related to school & work?

-School evaluates on the correct steps makes sure you follow the rules -Work makes sure how well you are following the procedures

What does the acronym STAMPEDAR stand for?

-Staring -Tone of voice -Anxiety -Mumbling -Pacing -Emotions -Disease process -Assertive/nonassertive behavior -Resources

How does the nurse approach someone who has experienced violence?

-Step out, ask for assistance, can't exactly avoid room -Bipolar, schizo, waiting for doctor to come in for biopsy results -Take somebody else to go with you, distant yourself -Step away and let them know what you're doing; use your communication techniques

How to overcome low self-esteem?

-Surround yourself with positive people -Set goals & expectations -Take time to treat yourself -Maintain a positive attitude -Remember, you are making it through nursing school -Offer to mentor students -Keep balance

How many stages are there to go from novice to expert nurse?

5 stages

Residency Programs

A better way to ease the transition from academia to practice and also may be a motivation for graduates when selecting that first job.

Compassion Fatigue

Gradual decline of compassion over time as a result of caregivers being exposed to events that have traumatized their patients, a decrease in compassion

Recovery Phase

Happens when the nurse sense of humor or desire to succeed returns. The novice nurse begins to understand the new culture and there is less tension and anxiety, and healing beings.

From novice to expert Stage 3

Includes competent nurses who are able to foresee long-range goals and are mastering skills.

From novice to expert Stage 5

Includes expert nurses for whom intuition and decision-making are instantaneous.

From novice to expert Stage 4

Includes proficient nurses who view whole situations rather than parts and are able to develop a solution

Role models

Usually don't have an interactive process like with a mentor. Someone the novice nurse looks up to.

What is an example of a native nurse?

Administering medications without knowing their action and side effects and the associated nursing responsibilities.

What are some symptoms a nurse is burned out?

Common symptoms include fatigue, negativity in person relationships, difficulty sleeping, excessive stress, anxiety, vulnerability to disease, depression, and alcohol or substance abuse.

*A novice nurse has just found out that her patient is having a hard time coping with his new terminal diagnosis. She does not ask the patient any questions and proceeds about her day. What is this novice nurse experiencing?

Compassion fatigue because the nurses compassion is decreased with the patient.

Type 3 Workplace Violence

Coworker (worker to worker). Employee or prior or disgruntled employees threaten or commit violence against current employees and/or management. This is referred to as vertical or horizontal violence.

Honeymoon Phase

Everything is going great (ex. Getting accepted into the nursing program). The new nurse is in orientation, only thinks positive thoughts.

From novice to expert Stage 2

Exemplifies advanced beginners who are able to perform adequately and make some judgment calls based on experience; most novice nurses enter the workforce during this stage.

Why is it important for a nurse to maintain a high self-esteem?

Individuals with high self-esteem can critically problem solve, tackle obstacles, take sensible risks, believe in themselves, and take care of themselves, they are effective and respond to themselves and others in healthy ways. They can accomplish more because they feel comfortable with themselves.

Mentoring

Is a personal relationship with a more experienced person willing to guide a novice or inexperienced person. Mentoring is an interactive, mutual, and personal experience.

What is Biculturalism for?

It is designed to enhance a positive self-image and help novice nurses set realistic goals for practice. This strategy allows the new nurse to introduce ideas or values brought from nursing school and integrate them into the work environment.

What are mentors?

Mentors are experienced nurses who must be willing to commit to a relationship with novice nurses to help them recognize their weakness and strengths.

What do mentors do?

Mentors help novice nurses set and reach realistic goals by reinforcing and recommending appropriate course of action and providing emotional support, Help them develop confidence and organizational skills, and to validate intuitive nations.

What is a runaway nurse

New nurses that find it too difficult, they may choose another occupation or return to graduate school to prepare for a career in nursing education to teach others their "values in nursing"

What kind of nurses would experience compassion fatigue the most?

Nurses who work in emotionally charged environments, such as hospice, emergency departments, and mental health setting, are likely to experience this reaction.

Preceptors

Preceptors orient the novice nurse to the specific nursing area, aid in socialization, and teaching skills that are deemed necessary. They help new graduates develop critical thinking skills, bridging the gap between theory and knowledge.

*A novice nurse is contemplating moving to another town to work in. The novice nurse states she wants to go to a facility that has a residency program. Why do you think this is important to her?

Residency programs provide didactic or program activities as well as one-to-one preceptor experiences for an extended time, increasing satisfaction (skill) of the new nurse and improve patient outcomes and safety.

From novice to expert Stage 1

The nurse has few experiences with clinical expectations, and skills are learned by rote; this stage usually occurs while completing the nursing educational requirements.

Resolution Phase

The nurses ability to adjust to the new environment. The nurse is positively able to work through the rejection phase, they grow more as a professional nurse during the resolution phase. Work expectations are more easily met, and the nurse will have developed the ability to elicit change.

Reality Shock

The result of inconsistencies between the academic world and the world of work. Occurs with novice nurses when they become aware of the inconsistency between the actual world of nursing and that of nursing school

What are Native nurses like?

They adopt the ways of least resistance, they mimic other nurses on the unit and take shotcuts

How do novice nurses deal with the shock (rejection) phase?

They either become natives, runaways, rutters, burned out, compassion fatigue, loners, the new nurse on the block, or change agents.

Burned Out

This type of nurse bottle up conflict until they become burned out. They enter energized but quickly lose interest in the profession. work to much, exhaustion, not sleeping well, frequently calling in sick, type A (aggressive people tend to have this)

A novice nurse completes a computer search on how to become an expert nurse. The novice nurse found benner's stages of becoming clinically competent and learned that most novice nurses enter the workforce at stage?

Two when limited judgment calls are based on understanding gained from previous experiences