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Unit 1 Essay


Unit 1 Essay Victoria Avery Northeastern University

Avery 2 The management of a patients health requires the contribution of many different members of the health care team. At the center of this collaboration is the nurse. Nurses are responsible for the basic care of the patient, including the administration of medication and basic testing, as well as for ensuring that other medical professionals complete the tasks necessary to ensure complete care for the patient. Their number one priority is the patient. They are the advocates and the organizers. As a nurse I hope to be working within the inpatient setting caring for patients undergoing treatment for cancer. I will be in charge or administering medication and basic tests, ensuring the patient is receiving adequate personal care, and organizing the contributing members of that patients care team. These members could include physicians, physical therapists, occupational therapists, psychiatrists, social workers, and various others. The ability to communicate with many different types of people is an essential skill for the nurse. As a nurse one must be able to prioritize the care that a patient will be receiving and ensure that it is completed. The nurse is also likely to have multiple patients; this means that the nurse need to learn to manage their time in a way that insures equal and appropriate care to everyone she is responsible for. In the hospital setting the communication between the nurse and her colleagues (as well as between her and the patient/family) is essential. There are many different ways in which the nurse communicates when she working in the hospital setting (White). The most frequently used method is through text pages and phone calls. Throughout the work day most members of the health care team will carry pagers on them. These pages allow them to communicate brief amounts of information in a way that will not interfere if the person holding the pager is in the middle of patient care. These pages are often followed up by phone conversations. These

Avery 3 telephone conversations often eliminate any confusion that could be created by written methods and often save time. When nurses need to communicate a greater amount of information that is vital enough to be recorded in the care plan they use a variety of documentation methods. The information documented in a patients chart includes (but is not limited to ): medical history and physical exam, nursing admission assessment, prescribers orders, physicians and nurses progress notes, laboratory and radiology reports, plan of care, flow sheet (includes times for vitals and daily care), Medication Administration Record (MAR), consents and client education records (White). The most standardized method of nurses communicating with other nurses is via a nursing note (White). This is a legal document that is placed in a patients chart. Some hospitals will have them electronically entered at the end of each shift, however many still use the handwritten method. A nursing note can be written in many different ways. The SOAP note method is a commonly used process of breaking down the information into categories. S is for subjective information gathered on the patient, O is for objective information, A is for the assessment that the nurse (and other health care providers) have made, and P is for the plan for the patient going forward. Another type of nursing note is a narrative. This is a less-used method, but still effective. Instead of breaking up the information into categories it is simply a story of the patients day as told by the nurse. The fact that the SOAP note is the preferred method of nurse to nurse written communication emphasizes the fact that nurses have a need to access specific information quickly. Nurses also communicate verbally at change of shift. As much as speed is important, accuracy remains the most imperative goal in the medical field. Because of this nurses make sure to communicate vital pieces of patient care to the oncoming nurse.

Avery 4 Nurses must also receive information throughout the day as they organize the care of their patients. They receive this information in various ways. Other medical professions, such as physical therapists, physicians, and social workers will leave notes similar to the nurse to nurse notes in order to communicate their findings and plans of care. Nurses may also communicate with other members of the health care team via the pager/phone system. Occasionally nurses will spend hours of their day on the phone receiving critical results, helping to determine a plan of care, scheduling tests, and conveying other important pieces of information. Another aspect of communication essential to nursing that is not always thought about is the nurses communication with the patient and their family. This information is most often verbal and involves breaking down the medical mumbo-jumbo into laymans terms. Although frequently over-looked this is arguably the most important part of the nursing process (White). In advanced nursing there is opportunity for research and study. In order to convey the results of this study to other members of the medical community, nurses must learn to communicate in the educational field. This means that many nurse will go back to school and learn to write papers and present in public forums. Without this dissemination of information it would be useless to complete the research. It is this frequent sharing of ideas and evaluations which allows the medical field to move at such a rapid place. The artifact that I have chosen to evaluate is from the Online Journal of Issues in Nursing. This website describes itself as a peer-reviewed, online publication that addresses current topics affecting nursing practice, research, education, and the wider health care sector. The specific article that I am looking at is Ethics: Ethics and Pain

Avery 5 Management in Hospitalized Patients. It is written by Esther Bernhofer who is an advanced practice RN. Ms. Bernhofer is the Pain Management/Education Coordinator for the inpatient Medicine and Digestive Disease Institutes at the Cleveland Clinic, Cleveland, OH. She is board certified (American Nurses Credentialing Center) in Pain Management Nursing and has a strong desire to see to the optimization of pain care for all hospitalized patients. This is an exerpt from the bottom of the article where Ms. Bernhofers career and background are explained. An email address is also provided if the reader is interested in contacting her further. The text works to inform the reader on her evaluation of the current situation regarding the process of treating pain in the hospital. The audience is educated health care professionals. The writer assumes a certain level of knowledge when explaining her thoughts and findings. It is however, broken down into much more simple terms which leads me to believe that it is geared at educating practicing nurses who are not currently in school but may be interested in advancing their practice. This text is published in an academic context. It is clearly a journal written for nurses by nurses. The article uses very clearly site reputable peer evaluated sources. One can see a bibliography at the end of the article. It is written is a categorical manner. The information is broken up in to clear sections with headers so one can easily peruse the article for specific information without combing through its entirety. When one breaks down the sentences used in the article, it is clear that the goal is simple the effective communication of the information at hand. The article is written in the third person. The importance is not to understand the writer, or even to really notice them, as much as to understand the ideas being communicated. The information is presented is not as strict and scientific as a study but not as comfortable and informal as a personal

Avery 6 piece such as a blog may be. The writer took the information found by others in more strict scientific studies (which are cited at the bottom of the article) and broke them down so that the other nurses in her field could benefit from the information discovered in these studies without wading through all of the technical pieces that are seemingly unrelated to the practice of these findings. Overall, this article is a great example of the way in which nurses communicate with each other. It is organized and easy to read. It is a collection of facts broken down into easily referenced categories. The writer has clearly followed a prescribed method for presenting the information and that is what makes it accessible to others in her field. As always in nursing, the writer has ensured that she can be communicated by anyone with questions as to ensure that there is no confusion surrounding the situation. She has included references in order to back her claims and has been published on a reputable site in order to instill confidence in the audience about work that she has done. It is a classic example of nursing communication.

Avery 7 Works Cited Bernhofer, E., (October 25, 2011) "Ethics and Pain Management in Hospitalized Patients" OJIN: The Online Journal of Issues in Nursing Vol. 17 No. 1.

White, L.; Duncan, G.; and Baumle, W.: Foundation of Nursing, 3rd ed., 2011, Australia: CENGAGE, P.P.173-190.