NRSG367 Alexa Graduate Registered Nurse Case Study Sample

• Subject Code : NRSG367
• Subject Name : Nursing

Transition to Professional Nursing

Introduction to Alexa Graduate Registered Nurse Case Study

The registered nurses are considered to be the backbone of the health care system as they are associated with the better health outcome which leads to the better patient experience. There are different roles of the registered nurse which includes conducting a physical examination, maintaining the medical record of the patient, following medication information and assisting patient in care (Flinter et al., 2017). Registered nurses are expected to follow standards and principles to work in the scope of practise that help to deliver the duty of care to improve the health status of the patient (Smolowitz et al., 2015). The case study is about a new graduate registered nurse Alex was is experiencing his first graduate rotation. He is facing an issue while dealing with his daily routine and managing the work-life balance. The essay will outline three major sections concerning the case scenario and the first section will include the analysis of the role of the graduate nurse can meet the professional role as per the case study information. The second section will include three recommendations and the last section will include evidence-based strategies to improve work-life balance. 

Justification of The Registered Nurse Role

Registered nurses are expected to deliver safe and quality care that not only stabilizes the patient health status but also improves health (Gómez-Villegas et al., 2015). There are many areas were Alexa has lacked in the professional role that has increase complication for the patient. One of the complications that were observed after reviewing the case scenario is the lack of monitoring of the patient. Mr O’Sullivan has recently undergone surgery and the patient is under anesthetic observation. Nursing and Midwifery Board, (2017) Standard 3 that is Maintains the capability for practise state that registered nurses are expected to respond on time for health and wellbeing concerning the scope of practice. The patient has recently completed his surgery and there is a need to continuously monitor the patient to avoid chances of post-operative complication that will directly deteriorate the patient health status. The case scenario indicates that Alex forgot to track the patient status after the administration of the antiemetic that can lead to the presence of the side effect that can deteriorate patient health status.

Another scenario that indicates that Alex has not able to justify his professional role that can increase chances of altered assessment that led to the wrong treatment process. The carelessness of the Alex toward the admission documentation of Mr Maple. The newly admitted Mr Maple that can lead to delay in the treatment process which can increase postoperative complication. The patients’ medical history indicates that the presence of hepatitis B and end-stage liver failure that need urgent attention. Nursing and Midwifery Board (2017) Standards 1 Think critically and analyses nursing practise state that timely documentation of the patient should be performed by the registered nurse to decrease the chances of complication concerning the health status of the patient.

The carelessness concerning the patient notes is also one of the duty breaches as a registered nurse that can lead to negative consequences over the patient. The patient notes are necessary during the shift change so that the nurse in charge can understand the current patient status and medication. Nursing and Midwifery Board (2017) Standard 3 also state that registered nurses are expected to actively engage with the profession to improve the clinical practice that supports the patient health status. The registered nurses are expected to properly maintain the patient notes to improve the documentation that is necessary to improve the care process. The patient notes are necessary to collect all the necessary pieces of information in one place which are necessary for the treatment process of the patient. 

These three incidents indicate that Alex is not able to justify his professional role that is important to deliver quality care. The incompatibility to manage the work-life balance directly impacted his clinical practice that can directly impact the patient health status due to delayed treatment.

The suggestion from the nurse preceptor concerning the practice is important to understand the gap in the clinical practises that need to be improved for delivery of the quality care. Alex was able to meet his RN role as consulting with your senior help to improve the perspective concerning the care that will help to improve the clinical practice.

Three Recommendations to Improve Shift

The first recommendation that can help Alex to improve the issue faced during the case scenario can be collaborating and partnering with colleagues to improve the care. One of the article presented by Schot et al. (2020) discussed that collaboration and partnership is important in healthcare whether it is patient or colleagues. The partnerships help the nurses to work in coordination to improve the patient health status that is necessary to better patient experience. Interprofessional collaboration is necessary to improve the health care services which are necessary to address the patient-specific need concerning the health status. The findings are also supported by Santos et al. (2016) by adding that teamwork is an essential component of the health care sector that is important to deliver patient-centric care. There are two types of team works that are incorporated in the health care sector that includes grouped teamwork or integration teamwork. Registered nurses are expected to coordinate with the team to improve patient monitoring and care to improve patient health status. The partnership will help Alex to get assistance from the colleagues in the patient monitoring when he was addressing other patients so that patient can be safe and there will be no chances of post-operative complication.

The second recommendation that will help Alex to improve the cases scenario is critical thinking skills that will help the registered nurse to work according to the scope of practice. The study presented by Papathanasiou et al. (2014) discussed that critical thinking is important for the nurse to deal with the situation while considering all the different aspect all-together. Critical thinking is important in the nursing profession to deals with the difficult situation by properly analysing, the interpretation which leads to better decision making. The nurses are expected to solve the complex patient issue and provide accurate decision to improve the care process. Critical thinking improves the individual capacity to evaluate the individual issue and process it to provide the right decision that is better for care. It was also supported by Azizi-Fini et al. (2015) added that one of the important nursing skills is considered to be the critical thinking that is important to deliver quality care. Critical thinking improves the reasoning skills of the nurse that are necessary to evaluate and interpret patient information to improve care. Critical thinking will help Alex to set the prioritize list concerning the patient that will help to remember all the aspect and provide accurate care to all patient.

The third recommendation that can improve the issues encountered by the Alex during the care in partnership with the patient that will improve the interaction which will increase the quality of the care. One of the studies presented by Pomey et al. (2015) discussed that patient partnership is important to improve the care perspective that is patient-centric which improve the patient health outcome. The partnership will help to improve the health care professional understanding concerning the patient perspective and improve patient participation in the care. The partnership helps the health care professional to consider the patient views concerning the care to improve the decision making that is necessary for quality care. Another study supported the finding presented by Grouse (2014) by adding that four-component should work in partnership to deliver the quality care out of which one important component is patient. The coordinate work between all the component help to deliver the personalized care that directly addresses the specific issue of the patient which will positively impact the health status. Alex can also incorporate partnership with patient in the clinical practice to improve the patient handling and reduce the carelessness of the clinical practice.

Evidence-Based Strategies

SMART goal setting is one of the evidence-based strategies that can help the Alex to maintain the work-life balance and it will help to set plan for every action so that outcome can match the goal of the intervention. One of the studies presented by Aghera et al. (2018) discussed that SMART goal setting is important to specify every component of the intervention to set a goal that is necessary to manage every activity with time. The SMART stands for specific, measurable, accessible, and relevant and timely it will help to set a particular period for intervention. A SMART goal is important to organize the different activities in the clinical practice which will manage the time of the nurse and improve the working pattern. The learning SMART goal helps the nurses to score their action which will help to improve the clinical practise that is necessary for the quality of care.

The second evidence-based method that can be utilized to improve the building capacity and resilience is the Conducting Training Need Assessment. It is helpful to improve the identification of the individual current capacity to improve the practice. The study presented by Mahmud et al. (2019) discussed that Conducting Training Need Assessment is important to evaluate the individual capacity concerning professional practice. The assessment includes a different test that helps the individual to understand the individual competency that can be compared with the desired competency to improve clinical practice. The step starts with the identification of the need followed by gap analysis then assess training option. The last step is the report training need that will improve the clinical practice.

These two evidence-based methods can help Alex to improve the work-life balance and build capacity which is necessary to justify the professional role and improve the clinical practice.

The essay can be concluded by adding that the registered nurse is considered to follow the standards and improve skills that are necessary to deliver quality care. Different points have been identified in the case study which reflects that Alex is not able to meet his professional role duty. Some of the issues are negligence toward patient monitoring, not documenting the admission report, carelessness toward patient notes and increasing patient susceptibility toward postoperative complication. There is a need to improve the practice by incorporating team-work, critical thinking and partnership with the patient to improve the case scenario and reduce the risk for the patient. The case indicates that Alex is facing an issue with work-life balance and build capacity that needs to be addressed by the evidence-based strategy. The two evidence-based strategies that can be utilized to improve work-life balance include SMART goal setting and Conducting Training Need Assessment. These methods will help the nurse to improve the interpersonal skill that directly improves clinical practice.

References for Alexa Graduate Registered Nurse Case Study

Aghera, A., Emery, M., Bounds, R., Bush, C., Stansfield, R. B., Gillett, B. & Santen, S. A. (2018). A randomized trial of smart goal enhanced debriefing after simulation to promote educational actions. The Western Journal of Emergency Medicine, 19(1), 112–120. DOI: 10.5811/westjem.2017.11.36524

Azizi-Fini, I., Hajibagheri, A., & Adib-Hajbaghery, M. (2015). Critical thinking skills in nursing students: A comparison between freshmen and senior students. Nursing and Midwifery Studies, 4(1), 1-5. DOI: 10.17795/nmsjournal25721

Flinter, M., Hsu, C., Cromp, D., Ladden, M. D. & Wagner, E. H. (2017). Registered nurses in primary care: Emerging new roles and contributions to team-based care in high-performing practices. The Journal of Ambulatory Care Management, 40(4), 287–296. DOI: 10.1097/JAC.0000000000000193

Gómez-Villegas, I., Ruíz-Pérez, B., López-del-Pino, D., & García-España, F. (2015). Professional nursing duties in the central services: Hospital pharmacy nurses. Advances in Nursing, 2015, 1–6. DOI:10.1155/2015/684373

Grouse L. (2014). Medical partnerships for improved patients' outcomes-are they working? Journal of Thoracic Disease, 6(5), 558–563. DOI: 10.3978/j.issn.2072-1439.2014.01.25

Mahmud, K. T., Wahid, I. S. Arif, I. & Belso-Martinez, J. (2019). Impact of training needs assessment on the performance of employees: Evidence from Bangladesh, Cogent Social Sciences, 5, 1, DOI: 10.1080/23311886.2019.1705627

Nursing and Midwifery Board. (2017). Registered nurse standards for practise. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Papathanasiou, I. V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K. & Kourkouta, L. (2014). Critical thinking: The development of an essential skill for nursing students. Acta informatica medica: AIM: Journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH, 22(4), 283–286. DOI: 10.5455/aim.2014.22.283-286

Pomey, M. P., Ghadiri, D. P., Karazivan, P., Fernandez, N. & Clavel, N. (2015). Patients as partners: A qualitative study of patients' engagement in their health care. PloS One, 10(4). DOI: 10.1371/journal.pone.0122499 

Santos, J. L. G, Lima, M. A. D., Pestana, A. L, Colomé, I. C. & Erdmann, A. L. (2016). Strategies used by nurses to promote teamwork in an emergency service. Revista Gaúcha de Enfermagem, 37 (1). DOI: 10.1590 / 1983-1447.2016.01.50178 

Schot, E., Tummers, L. & Noordegraaf, M. (2020). Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. Journal of Interprofessional Care, 34(3), 332-342, DOI: 10.1080/13561820.2019.1636007

Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E.-M., Ulrich, S., Hayes, C. & Wood, L. (2015). Role of the registered nurse in primary health care: Meeting health care needs in the 21st century. Nursing Outlook, 63(2), 130–136. DOI:10.1016/j.outlook.2014.08.004 

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