Paper Sample: Engagement in Professional Nursing

Introduction

Hung et al. (2016) define organizational culture as the implicit values or knowledge within an institution that portrays the traditions and norms of the institution. The vision, values, and visions of an organization, ascertained by leadership, present the foundation for organizational culture. Because organizations have individualized vision, mission, and value statements, every institution has a unique culture. Hence, it is clear that whenever there are mismatches between the vision and mission of any organization, teamwork in delivering services to a consumer or patient can result in conflicts and disagreements (Ko et al. 2015). With the mounting focus on cooperation between healthcare facilities, it is vital to comprehend how to defeat the challenges of different organizational cultures that may hinder teamwork exertions. Hence, the paper is a personal reflection of how corporate culture and structure can interfere with the provision of patient-centered care.

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Organizational Structure and Culture

A Time Where There Was a Safety Concern

The primary patient safety issue that I have witnessed at the hospital is patient falls. About 700,000 to 1,000,000 people in the US fall in healthcare facilities every year (Ranji, 2019). Falls at the hospital mainly occurs when a patient who cannot walk on their own try to get out of bed regularly to go to the bathroom. Falls are a typical reason for injury inside and outside of the health facility. Injuries due to falls include bone breaks and may lead to fatalities

The issue was addressed by making improvements and adjustments to environmental conditions that limit the risk of falling. The interventions include flooring to absorb the effect of a fall, proper lighting of corridors, and handrails to assist with ambulation (Ranji, 2019). Trip hazards were removed using inclined edges, raised edges, and marking trip risks to improve permeability. Yes, we, as nurses, were able to speak about the problem of falls. We raised our concern to the management because falls increased hospital stays for the patient and falls were a major cause of hospital readmission for older adults (Prusinowska, Komorowski, Sadura-Sieklucka, & Ksiezopolska-Orlowska, 2017). Hence, because of this, it often interfered with our Medicare reimbursements.

Organizational Culture that Promotes Speaking Up

Several elements may determine the voicing behavior of employees. Silence can result from fear, the urge to prevent communicating unwelcome concepts or bad news, and existing social and normative pressures (Xu, Qin, Dust, & Direnzo, 2019). Besides, hesitance in voicing or indicating errors can be due to uneven authority gradients, extreme professional politeness, and inadequate task or resource management (Xu, Qin, Dust, & Direnzo, 2019). The organizational culture that enables us to speak up as nurses is a transparent and democratic corporate culture. Our leaders have established standards, behaviors, and expectations to foster condor. The leaders start by discussing what went wrong, their responsibility for what went wrong, the lesson learned, and the intervention implemented to limit the damage.

The system at the workplace that enables us to speak up is the adoption of Morrison's model of employee voice (Okuyama, Wagner, & Bijnen, 2016). In the model, it is assumed that the motivation for voice is the urge to assist the organization to function more effectively or make a positive collective contribution. The voice portrays a thoughtful decision mechanism where an individual contemplates both the negative and positive outcomes and the understood safety and efficacy of voicing their issue (Okuyama, Wagner, & Bijnen, 2016). The observed efficacy of voice is the judgment of the individual, whether it is possibly useful. Also, the sensed safety of voice is the judgment of the person concerning the risk of likely negative consequences. Though the model by Morrison provides a basic framework, however, since we are in a clinical setting, two elements must be considered. The first element is the kind of information being communicated is generally of concern (Okuyama, Wagner, & Bijnen, 2016). The second element is that while in organizational setup, speaking up is often associated with the goals and well-being of the organization and its employees in health care setup for patient safety is primarily aimed at promoting the health and safety of patients. Hence as a nurse, the organization allows me to voice my concerns regarding patient safety in line with beneficence.

The Role I Have as a Graduate Nurse

As a graduate nurse, to speak up on patient safety issues, there are specific roles I can play. First, I will be able to analyze data on the hospital's safety culture so that I can be able to voice my concerns on the areas that need improvement based on my hospital's unique features (HEALTHCARE Business & Technology, 2017). Secondly, I would evaluate the current safety culture performance at my hospitals. I would use evaluation tools such as the Hospital Survey on Patient Safety Culture to see how my facility performs to voice my concerns on how the performance may be improved. As a nurse graduate, I will promote a safety culture behavior among my peers and encourage them to speak up when they notice a safety issue. I will also urge them to operate with no maleficence and beneficence (HEALTHCARE Business & Technology, 2017). Besides, I will promote the culture of safety at the hospital by advocating for policies that promote patient safety and policies that promote the reporting of adverse events. I will foster transparency in reporting error cases, and establish specific policies addressing the procedure for reporting adverse events and close calls (HEALTHCARE Business & Technology, 2017). I will also provide advice on developing team-based training fixed on safety culture. Teamwork is essential in guaranteeing the safe treatment of patients. Nurses have to know how to collaborate with other healthcare professionals to promote patient outcomes successfully.

Health Informatics

My Experience with Health Information Systems

Health informatics employs technology to arrange and analyze health records to promote health care outcomes. Healthcare informatics affords secure electronic access to medical records for patients, nurses, doctors, insurance firms, hospital administrators, and health information technicians (Rose, Richter, & Kapustin, 2015). The health informatics system that I have managed to encounter and experience is the Electronic medical record (EMR) system. EMR is an electronic record of health-associated on a person that can be generated, collected, managed, and referred by authorized staff and clinicians within one healthcare facility (Salameh, Eddy, Batran, Hijaz, & Jaser, 2019). EMR can offer substantial advantages to clinic practices, physicians, and healthcare institutions (Rose, Richter, & Kapustin, 2015). For example, it provides computerized order entry, provides computer-based decision support systems to avert drug interaction, and provides safe electronic communication between providers hence promoting health care collaboration.

Enabler or Barrier That Influences the Effective Use of Health Informatics Systems

There has been a transformation from the conventional paper-based health record being replaced by an electronic-based documentation system in most healthcare facilities globally. The shift to EMR/EHR has been associated with numerous advantages. For instance, as a nurse, I no longer need to understand the illegible handwriting of physician documentation, which improves the quality of my nursing documentation. Therefore, it reduces any medical errors due to misunderstood orders (Johnson, Sanchez, & Zheng, 2016). Hence, with HER, including all essential data of patients, I have access to everything I may need to deliver high-level and safe care. Besides, transferring medical data from one health environment to another one becomes is just a click away (Johnson, Sanchez, & Zheng, 2016). Hence, due to reduced medical errors that can threaten the safety of patients, EHR will help me in achieving my goal of promoting patient safety.

However, as a graduate nurse, my experience with using EMR has been frustrating due to the security and privacy apprehensions associated with the electronic transference of health data from one health facility to another. According to Kirimlioglu (2017), EMR is a computerized documentation system that holds all the medical history of a patient; hence there is a need to ensure the confidentiality, security, and privacy of the data. Privacy is essential since it promotes or enables basic values, including ideals of personhood—for example, personal autonomy, individuality, respect, and dignity (Kirimlioglu, 2017). The ethical principle of nonmaleficence demands protecting personal privacy, and breach of this privacy to disclose patient data may lead to embarrassment, stigma, and discernment. Hence, due to these privacy issues, I have not been given complete authority to access the EMT interface and security clearance, which negatively influences my use of health informatics systems. Besides, the hospital ha stringent rules on who can access patient files and any staff that inappropriately acquires patient documents are terminated.

My Role as a Graduate Nurse in Ethics Use of HIS

Conferring to USF Health (2020), AHIMA's Code of Ethics states that the ethical mandate of HIM professionals comprises protecting the security and privacy of health data, disclosure of health data, and development, application, and maintenance of HIS and health information. The HIM professional is tasked with ensuring the accessibility and truthfulness of health data. Hence, my duty as a graduate nurse is to ensure the ethical use of HIS by upholding ANA policies and legislations that maintain standards for safeguarding patient data (USF Health, 2020). Data breaches may occur if the information is misused or not secure. I will promote the ethical use of HIS by avoiding the following unethical decisions; failing to log off a computer when it is not used, unlawfully accessing a patient file, lending access codes or passwords to unauthorized colleagues, and losing necessary electronic devices (STU Online, 2019). Also, I will avoid shredding printouts that have confidential patient information and prevent patients from texting information to friends or colleagues (STU Online, 2019). Furthermore, there is an overall tendency of nurses to over-rely on the EHR systems, which is an unethical use of HIS. As a nurse, I should be capable of providing patient care, even in the absence of technology.

Transition to Practice

Wong et al. (2018) state that all nurses have undergone a turning point in their lives, from being student nurses to staff nurses. Nurses require a period to adjust to a change of identity, responsibilities, roles, and a novel setting, especially when shifting from a protected environment where their teachers monitor them to a real world where they are tasked with providing care afflicted. Studies by Parker et al. (2014) and Salt et al. (2008) demonstrate that transitional issues, such as stress and job dissatisfaction, compel new nursing graduates to abandon their jobs leading to high turnover rates. Some of the challenges faced by nurse students during transition include:

Works Cited

Wong et al. (2018) carried out a study on the transition challenges fresh nurse graduates experience in Hong Kong. In the study, the participants underwent heavy workloads and stated that the average ratio of nurses to a patient is 1:12, while the most meaningful rate is 1: 21. Substantial workload comprised substantial paperwork and management...