Discussion Response

This is a discussion response. Please address this as if you are talking to a colleague. DO NOT critique their grammar!

**The response must offer additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

**Must include references!

This is what needs to be responded to:

There are several strategies a nurse can employ to empower patients and support patient rights. In the media presentation, Nitza Santiago discussed the direct impact involving patients in their own care has on the quality of their care and overall safety (Laureate Education, 2009). As nurses, it is our job to advocate for our patients, a great way to do this is to make sure our patients (If able to) understand and take part in their own care. By doing this, patients will have a better understanding of why things are being done, the next step in their treatment and what the overall goal is. The Patient Care Partnership discusses some other strategies that we are able to utilize. Some include privacy protection during and after care, collaborating with doctors and interdisciplinary members about treatment options, educating and assisting related to health care insurance and programs, and discharge education, referrals, and follow-ups (American Hospital Association, 2003). By keeping our patients involved in their care from the moment their treatment starts and continuing after discharge, we are assisting with an overall higher quality experience and empowering them to take positive steps with their on healthcare once they are on their own at home.

             “The National Database of Nursing Quality Indicators is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level” (Montavlo, 2017). This is the first true database that gives a national benchmark for individual units to assess how their nurses are comparing and it can be used to support nurse empowerment in their practice. During the media presentation, Dr. Kenneth Rempher discusses how this is the first time that nurses can be held accountable for how their unit is doing compared to national numbers (Laureate Education, 2009). Once nurses on an unit see the number, see the facts, there is no way to turn an eye, change needs to occur. It gives the nurses the chance to make the change on the unit; the individuals are doing the practices day in and day out are now able to take the necessary steps to advance their unit. These nurses are then able to educate other units, other hospitals and even go to conferences where they can present their findings and what they did to make the positive change so other units can do the same (Laureate Education, 2009). 

             According to Giancarlo et al. (2014), “Job dissatisfaction in the nursing work environment is the primary cause of nursing turnover. Job satisfaction has been linked to a high level of empowerment in nurses”. Having high turn over rates can lead to short staffing, high patient ratios, increased burn out rates, even more nurses leaving the unit, and ultimately job dissatisfaction (Giancarlo, 2014). One thing our hospital did to help with increased turn over rates was to initiate New Graduate Residency Programs. This programs is for nurses that have recently graduated and became RNs. When they are hired at the hospital, they take continued courses specific to the area they will be working in for a year and then sign a 3 year contract with the individual unit they are working on. The idea behind this is to give the new nurses more education to feel more comfortable in this specific area and to prevent nurses from just taking a position for a year and then transferring out but to really only have people apply to the position who want to work there. 

              While I was working on a Progressive Care Unit, I had an elderly male patient. He had his girlfriend as his health care proxy. When this patient was admitted to us, he was sick but his condition worsened and he ended up intubated; we believed his condition could turn around with advanced treatments. His daughter called the unit everyday to check on him, but unfortunately we were unable to give her information due to HIPPA. The daughter became very concerned when she realized that her father was no longer able to take phone calls in his room. After speaking with the girlfriend and the daughter, we found out that the girlfriend was giving false medical updates to the family because she did not believe he was as sick as we were telling her and started to refuse further medical treatments for him. The nurses and the medical staff believed that he could survive this if treated appropriately. We were able to get an ethics consult, included both the girlfriend and the daughter, as well as several interdisciplinary teams. Once the ethics team was involved, the girlfriend agreed to turn over the health proxy to the daughter (the girlfriend said this is what the father would have wanted), we were able to continue with treatments of the patient and after a couple of months, he was able to walk out of our unit. The patient was extremely grateful that ethics became involved, his daughter took over making medical decisions, and ultimately saved his life. 

                                                                                                                                                              References

                American Hospital Association. (2003). The patient care partnership: Understanding expectations, rights and responsibilities. Retrieved from http://www.aha.org/content00-10/pcp_english_030730.pdf

                Giancarlo, C., Comparcini, D., & Simonetti, V. (2014). Workplace empowerment and nurse’ job satisfaction: a systematic literature review. Journal of Nursing Management, 22(7), 855-871. Doi:10.1111/jonm.12028

                Laureate Education. (Producer). (2009a). Topics in clinical nursing: Accountability and nursing practice [Video file]. Baltimore, MD: Author. 

                Montalvo, I. (2007). The national database of nursing quality indicators. The Online Journal of Issues in Nursing, 12(3). Retrieved from http://www.nursingworld.org/ainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122002/No3Sept7/NursingQualityIndicators.html