Tuesday, October 28, 2008
Week Three
Congratulations! You have just been promoted to nurse manager of the Mother/Baby or Labor & Delivery unit (your choice). Your first task is to keep the excellent level of patient care even though your hospital is adding 7 new obstetricians on staff and adding more patient rooms. List one important thing you will do to secure excellent patient care. Give rationale for your choice. Please do not use a strategy that another student uses.
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22 comments:
If I were nurse manager of a labor and delivery floor, my number one concern pertaining to quality of patient care would be directed towards making sure there were enough nurses available on staff to still maintain a nurse/patient 2:1 ratio due to the increased amount of patient rooms. This is my main concern because more patiens equals less individualized time with the patients, leading to decreased quality care and labor experience. The extra patient load increases the likelihood of more medication errors and quicker burn-out rates for the nurses. I would address it by hiring more nurses, asking for input from the nurses,and making sure to keep schedules and daily assignments organized and visible to the staff.
If I were nurse manager of a labor and delivery floor that anticipated a sudden increase in patient census, I would plan on maintaining high quality patient care by providing support for the new and existing nurses by implementing inservices, promoting team spirit, and encouraging them with one-on-one visits, even if only for a few minutes standing and talking at the nurses' station.
To give excellent patient care I would make sure that upon admission to the unit and during the initial assessment I would do the following: to ask if any stressful events had taken place recently, more about her thoughts of pregnancy and support systems during and after pregnancy. The rationale for this is related to the experience that I had today in clinical. labor and Delivery is such an emotional and strefful time. Emotions run high and if there is preexisting events that are not known then as a nurse you can't prepare for the unexpected.
Laura
To promote excellent patient care in Labor and Delivery I would increase communication between patient, nurse, and doctor. From what I have seen, communication is vital for excellent care. Doctor's and nurses must work together to provide quick, effective, and satisfying patient care. Including the patient is also vitally important because they are the "customer". They can provide information that no one else can. The other big part to my rational for choosing communication is that change (for the better of course) starts with voicing ideas and concerns.
Sheila
I would ensure an adequate orietning time for the new doctors to the hospital. They could team up with other doctors/nurses to make sure they know all protocols and important information about the hospital itself in order to provide great pateint care and eliminating any doubt about the new job
As a nurse manager of a L&D floor that is expanding and adding new doctors and beginning to hire new staff I would call a staff meeting to let my nurses know what changes are going to take place, who the new doctors are and where they are coming from, as well as to prepare them for the new staff that will be hired. I think that keeping your staff informed of changes and what to expect will lower the anxiety and promote a "team" atmosphere as well as prepare the hopefully seasoned staff for some new additions and that thier help in educating them will be essential.
As nurse manager, patient safety is always priority. If possible, I would add a nurse's station closer to these extra rooms. This would also provide more space for the larger number staff to work. Keeping work areas close to pt rooms would also help increase efficiency and limit staff exhaustion.
As nurse manager of the Mother/Baby unit, I would promote the change as positive by encouraging my nurses to voice their opinions and become involved in goal-setting. I would make myself available to the nurses on an individual basis to hear any concerns they may have. Working with new doctors and increasing patient loads can be quite overwhelming for a nurse who has become used to doing things his or her way. Again, I would stay positive about the change and remind my nurses that our patients are our number one priority.
The first thing that I would do as the nurse manager on the labor and delivery floor would be to orient my new nurses to the floor and have a meeting where all of the new nurses and doctors meet so that everybody knows the one specific goal of safe quality and effective care. As the healthcare team the doctors could talk about what they expect from my nurses and the nurses would have a chance to voice what they would like in return from the new doctors. The number one thing to keep in mind with new professionals who have never worked together is communication.
First, I would try to obtain some hard data on the expected increase in patients. Because of the additions, what is the expected increase of patients? Are the doctors bringing potential patients with them (such as the case at HH) or are the doctors new grads without an existing patient load? This information would give me a clue as to how many additional nurses I would need to hire to ensure quality care for all patients. I would also consider hiring additional trained/experienced support personnel (techs) to ease workload of nurses.
As a nurse manager in labor and delivery, I would try to ensure that the patients are getting highest level of nursing care provided for them. I realize nurses spend only nine prcent of their time supporting their laboring patients. First, I would see if hiring doulas and additional prn nursing staff would be within our budget. Second, I would give the nursing staff a chance to offer suggestions to resolve this problem. This would give them a voice. The increase in nursing staff along with the doulas will ensure that the safe effective care is being given at all times.
As nurse manager, one of the important concerns of adding extra rooms and doctors would be to ensure that there was adequate equipment stocked to provide for the extra patient census. If this aspect is not ensured, then a shortage of supplies and equipment may cause a emergency situation. Also, informing the staff of the new set up and making sure they are familiar with the new setup.
As the nurse manager of a L/D floor that was adding rooms and obstetricians I would also hire more nurses. Quality care is my number one concern and if you add more rooms you are adding more patients. The more patients each nurse has to take care of the lower the quality of care goes. I would encourage my nursing staff with positive comments regarding the change as well. This would be a way to make a positive impact in more patients lives.
As nurse manager of Labor and Delivery I would want to make sure there was good communication among all the staff. Since there are new doctors on board communication is vital for safe and efficient patient care. It is important to make sure all the staff are on the same page and understand all the hospital's policies. This could be done through meetings, handouts, online courses, and postings throughout the nurses stations.
To ensure excellent patient care as a nurse manager I would make sure that the all the new staff as well as the old staff were updated on the policies and procedures as they may differ than their previous place of employment. This would ensure that all staff are performing to the correct standards as well as delivering excellent patient care. This could be done by having a meeting with all staff members.
As the nurse manager my priority goal would be to facilitate a healthy relationship between my nurses, the new doctors, the increase in patients, and new facility. This may be achieved in a variety of ways including meetings which involve both the nurses and new docs... Give everyone a fighting chance at getting to know one another and begin communication.
IF I were the nurse manger of a labor and delivery unit, I would make sure that each patient had a visit from a social worker periodically during their stay. Like the others hace said I would also make sure that the nurse to patient ratio was adequate. I would also make sure that the cost of expanding the unit and hiring new nurses and doctors to fill it would not negativly inpact patient care.
As nurse manager of labor and delivery one of my concerns with adding new doctors and extra rooms is that there would be more patients than what the staff was accustomed to so i would need to hire enough nurses to adequately care for the increase in patients. Another concern would be that the nurses and doctors become accustomed to each other so they can work together efficiently to provide the best care for the patients.
The number one priority of quality patient care would be an advocate to every patient and baby. I believe it is top priority to be there for your patient and be on their side at all times.
As a nurse manager of the L&D the patients are still first priority. According to statistics the nurses already don't get to spend enough time with their patients. It is important to make sure that there is a good patient-nurse ratio so that they can focus on great care. It is a very important day in a family's life so we need to make sure that the nurses are available to make the process a good one. It is also important to work with your staff to make sure they are happy so that they will continue to do a good job.
As a nurse manager for the Mother-Baby floor I would make sure new moms had adequate teaching before discharge. This teaching would include all necessary information pertaining to that individual. To insure that the teaching was performed correctly, all of the nurses on my floor would need to have the proper knowledge to teach. The insure that each nurse can teach a patient to care for herself and her baby, inservice classes would be set up and made available to each shift, and be mandatory. By teaching patients and correcting knowledge deficits, the nurse would be empowering the patient and helping to reinforce positive habits that may be passed on to their children.
As a nurse manager on mother baby I would make sure that I was on the floor to let the nurses know that I am there with them to help with the changes. By being on the floor helping with the extra workload I would be able to observe the work being done and develop ideas that would help maintain the extra patients. I would encourage my nurses to come to me with any concerns and to offer ideas as to how we needed to work as a team to maintain the workload.
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