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Engagement in Professional Nursing

Organizational Structure and Culture

After graduating from a respectable institution as a nurse, I and a group of other 4 nurses were allotted to look after the ward of the Cardiology department in a health center in the outskirts of the city. It was the time when pandemic just struck. There was extreme pressure on the working staff of the hospitals. I and my group had to look after the whole floor of patients. The situation was full of distress and the working timings were absurd. I understood the criticality of the situation. But things seemed to go off the hands when the timings started hazarding the health of the nurses. The hazards could have impaired the physical as well as the psychological dimensions. It must be made sure that the nurses must return back to their families with proper mental and physical health. I and my fellow health workers were able to speak about the pressure that we faced while serving in the ward. The only way to deal with it was to inform the authorities about the lack of manpower. We further validated that the work must be done in shifts to manage the pressure that was occurring while nursing. It made me feel satisfied that I was able to express myself in concern with safety for ourselves.

The organizational structure that helps to speak up is about feedback. The safety culture program in the organization helps to open up with the difficulties faced by the employees. It is also useful in delivering safe, reliable, and quality care to the patients. It is important to create a culture of feedback where the workers are able to provide their opinion and choices. It reduces miscommunication and helps in providing care to the needy. Through this culture, not only the patients but also the staff and the workers are provided with sufficient space where they can express themselves. The physical and mental health of the workers and the nurses are also of great importance(Thitchener & Herco, 2016). There is a deep relation between the service and the environment. The availability of the chance to express what is wanted and what is not affecting the efficiency as well. Some guidelines can be developed to get the sources that cause occupational stress. Following the guidelines, the negative influence on the health and well being of the work-life of nurses can be removed. According to Mellor et al., training should be arranged for the nurse that will frame the new situation in front of them and they can learn what can be done in that situation. The management of the situation along with occupational health is very vital. This training opens the scope of thinking about the perceived situation in a real way(Mellor et al.,2006). Safety in the workplace means being safe from any sort of harassment, violence, mental, emotional, and psychological safety. The workplace must ensure that all; this safety must be provided to the nurses working in the service of the patients. For every step that is taken, a detailed plan must be made so that the safety and health of the nurses can be assured. It is very important to understand that nurses play a vital role in taking care of patients. Every organization must take care that the nurses are given enough chance to remove their stress so that they can provide better service to the ailing patients.

As a graduate nurse, I can speak up for safety by following and developing sustainable staffing for sharing the workload. This step can ensure the time shifts for the nurses working in the department. Physical safety can be ensured here. It can help in giving relaxation from the stress of continuous service. The stress may cause cognitive harm to the nurses. The lack of sleep occurred due to continuous shift hampers the class of service provided by the nurses. The shifting can help a lot in proper divisions of the work(Vaismoradi et al.,2020). Throughout, the family life and work balance will be maintained. Some other steps that can ensure a safe work environment can be thorough professionalism in nursing while looking after the patients and adapting good leaders who can maintain the flowchart of the work in the prescribed department. The leaders can make sure that all the work pressure must be equally divided to all that will stop the negative impact of the extra work on particular nurses or the group. It thus becomes very important to ensure the safety and well being of the nursing force so that it does not affect the working of the health care and the patients.

Health Informatics

Nursing documentation plays an important role in understanding the patient's history. While serving in the ward, I used the EMR or Electronic Medical record. The record is basically meant to serve the purpose of knowing the slightest of the improvement or history of the health of the patient(The Royal Children’s Hospital Melbourne, 2017). It is the entered information according to the shifts by the nurses. It is helpful in providing guidance in nursing. I was benefited by the record. It helped me assess the patient and I accordingly planned the tests and treatments that were required by the patients. The outcome was noted by me in the record. The results help in assessing the improvements and treatments that might be required in the future. The EMR can include things like abnormal assessment, family-centered care, social issues, change in clinical care, and a few more.

Though EMR is quite easy to use and is user friendly, it can be a barrier to many in some ways. In the times where technology has helped mankind in saving manual labor and made the progression easy, the EMR in the medical line has also helped in making the information up to date in patients' concerns and is also time-saving. The EMR is information about the health history of an individual that is stored digitally. As Ajami and ArabChadegani stated, the EMR is quite expensive due to this reason. The digital invasion requires equipment. The buying of the equipment is not possible to small health centers unless they are financed in that field(Ajami & ArabChadegani, 2013). It requires investment which is not possible to afford health centers in rural underdeveloped areas. As Palabindala and his colleagues stated in the journal, it is not just limited to installation but the maintenance needs high finance so that it can work effectively. In a nutshell, it demands high expenditure. Clinical and workers also need to adapt to the utilization of technology. But it cannot be achieved with ease as it requires training. The applications used in EMR are not always standardized. The less standardized software leads to mistakes in billing or miscommunication of the information. The system tends to hang if not used in proper software. The use of EMR is sometimes tricky and many clinicians prefer using pen paper instead of the EMR as using EMR requires technical training. Not all health workers are technical experts who can use these technologies without any difficulties as it requires time to learn and get adaptable to the technology(Palabindala et al., 2016). The issue here that arises is EMR is effective in providing information about the patient and health history. With the advent of technology and the new age software, the EMR is effective in recording history. But the health centers which are not comfortable and are not user friendly require help in the use and the technology demands finances. The availing of finances is not possible for the health centers which becomes a barrier in the installation of the technology.

As a graduate nurse in health care, I withhold a strong opinion that healthcare centers can use the EMR efficiently. The health care workers are provided with w boon in the disguise of EMR. The EMR assesses and notes the individual’s health history altogether. The health history helps in assessing and judging the situation of the patients(Lambooij et al., 2017). As stated by Lambooji et al., in his journal, the EMR requires training on its usage. It is the responsibility of the head of the department to ensure that sufficient training must be given to the nurses that enables them to use the device correctly and ensure no mishap in the treatment of the patient(Lambooij et al., 2017). The EMR even includes the social and financial status of the patients. The social factors also decide and influence the health of the individual. It is thus helpful for shifting nurses and health workers. The improvement and the deterioration of the health are updated and the workers coming in other shifts can go through the details without any problems. As a graduate nurse, I will be able to fill the EMR according to the requirements with little training and will be able to make it as a guide for others regarding patients who come for the next shift in the ward. The patient's EMR will also help in treating him appropriately and the results will be beneficial for the ward as well as the patient.

Transition to Practice

Nurses encounter problems in the transition from a student to getting into a professional field. There can be many issues such as role transition, communication issues, lack of knowledge, and a few more. Nurses need time and patience to adapt to this new transition. It involves a change in the roles where once they were supervised by their teachers in a protected environment and suddenly they are into the real-time situation where they have to take care of the patients. According to Wong et al., the first transition is the workload. They mentioned that the ratio for the patient to nurse was 1:21 instead of 1:12. This shows a large gap and a lot of load in treating and looking after the patients in particular wards. The sudden increase in the workload. A heavy workload can mean here as a pile of paperwork that is done regarding the patients along with the multiple tasks surrounding other patients. It can include providing treatments to ailing patients after the doctors visit the ward, answering the queries of the patient’s families, and frequent monitoring of the heavy drugs. When there is insufficient manpower in the wars, the workload tends to increase causing mental and physical stress on the nurses. There can be chances that the nurses tend to miss their meals causing hazards to their health. The average overtime usually lasts from 20 to 90 minutes on average(Wong et al., 2018). As Law and Chan state in their journal, the working atmosphere with workload leads to anxiety where the newly graduated nurses experience. The anxiety caused due to expectations. This raises worry among them as they think they will be gossiped about by their colleagues on a performance basis(Law & Chan, 2015). The issues concern the overall performance of the freshly recruited nurses and it is to be dealt with perseverance.

Nursing is a strenuous profession with workload and pressure. Despite being in such a situation, nurses never give up and have optimistic views regarding life and the profession. In this case, it becomes important for nurses to be acquainted with self-care. There are many ways by which nurses can make yourself relaxed and healthy. According to Mills et al., the two interventions that can be followed is physical self-care which includes eating the right meals at the right time. Taking all possible measures to take care of physical health which is very important in this profession. Apart from eating right, they must go for regular health screenings wherein they can come across any infection or disorder that has been inflicted in the body. Maintaining a proper weight and maintaining the hygiene of the body is one of the important factors in physical self-care.

Spiritual self-care is vital for the proper functioning of the body(Mills et al., 2018). I also feel that yoga and meditation must be included in the lifestyle which enhances spiritual thinking. Practicing Yoga and meditation helps in bringing positivity in life. It promotes joy and releases negativity from life. Building and nurturing special relationships give space in life and giving time to family help in gaining compassion and love

The positive workplace behaviors that can be implemented are foremost, the trust among the workers. The efficiency in teamwork comes from trusting. The trust factor plays an important role in almost all fields of life. The team must be engaged with the feeling that the work can be done if the task is done with trust. It helps in bringing colleagues together to fulfill the duty within the allotted time. Mistrust influences team work ability. I guess it becomes important to have faith and trust among the team.

The communication factor plays an important role here. The most efficient way to make the work done is by communication. The team leaders must make sure that all the information is regulated within the newly recruited nurse. As stated by Logan, the miscommunication of information or details can lead to mishaps that directly affect the treatment of the patients in health care. A lack of communication not only leads to mishaps in treatment but also affects the efficiency of teamwork and puts a negative effect on the performance of the organization(Logan, 2016). Both interventions deeply influence workplace behavior. Adapting both ways can make the workplace positive for nurses who are newly recruited. Workload also gets divided if the communication is done in a proper way leading to trust among the workers exfoliating the feeling that unity can make things done in any possible way.

References for Occupational Health Nursing Practice in Australia

Ajami, S., & ArabChadegani, R. (2013). Barriers to implement Electronic Health Records (EHRs). Materia Socio Medica, 25(3), 213. Retrieved from: https://doi.org/10.5455/msm.2013.25.213-215

‌Lambooij, M. S., Drewes, H. W., & Koster, F. (2017). Use of electronic medical records and quality of patient data: different reaction patterns of doctors and nurses to the hospital organization. BMC Medical Informatics and Decision Making, 17(1). Retrieved from: https://doi.org/10.1186/s12911-017-0412-x

Law, B. Y.-S., & Chan, E. A. (2015). The experience of learning to speak up: a narrative inquiry on newly graduated registered nurses. Journal of Clinical Nursing, 24(13–14), 1837–1848. Retrieved from: https://doi.org/10.1111/jocn.1280 

Logan, T. R. (2016). Influence of Teamwork Behaviors on Workplace Incivility as it Applies to Nurses. Creighton Journal of Interdisciplinary Leadership, 2(1), 47. Retrieved from: https://doi.org/10.17062/cjil.v2i1.28

Mellor, G., Winsome, S. J., & McVeigh, C. (2006). Occupational health nursing practice in Australia: What occupational health nurses say they do and what they actually do. Collegian, 13(3), 18–24.Retrieved from: Retrieved from https://doi.org/10.1016/s1322-7696(08)60528-4

Mills, J., Wand, T., & Fraser, J. A. (2018). Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study. BMC Palliative Care, 17(1). Retrieved from: https://doi.org/10.1186/s12904-018-0318-0

Palabindala, V., Pamarthy, A., & Jonnalagadda, N. R. (2016). Adoption of electronic health records and barriers. Journal of Community Hospital Internal Medicine Perspectives, 6(5), 32643. Retrieved from: https://doi.org/10.3402/jchimp.v6.32643

The Royal Children’s Hospital Melbourne. (2017). Clinical Guidelines (Nursing) : Nursing Documentation Principles. Retrieved from Rch.org.au Retrieved from: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/nursing-documentation-principles/

Thitchener, K., & Herco, F. (2016). ISQUA16-2321SPEAKING UP FOR PATIENT SAFETY SURVEY. International Journal for Quality in Health Care, 28(suppl 1), 50.1-50.Retrieved from: https://doi.org/10.1093/intqhc/mzw104.78

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ Adherence to Patient Safety Principles: A Systematic Review. International Journal of Environmental Research and Public Health, 17(6), 2028. Retrieved from: https://doi.org/10.3390/ijerph17062028

‌Wong, S. W. J., Che, W. S. W., Cheng, M. T. C., Cheung, C. K., Cheung, T. Y. J., Lee, K. Y., … Yip, S. L. (2018). Challenges of fresh nursing graduates during their transition period. Journal of Nursing Education and Practice, 8(6), 30. Retrieved from: https://doi.org/10.5430/jnep.v8n6p30

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