This writer is currently employed as a certified nurse case manager for a large insurance company, although I continue to work registry at the local community hospital. The insurance company’s structure is quite different from the hospital setting. The insurance company team consists of registered nurses, social workers, professional counselors, two medical directors, one medical and one psychiatrist, and an abundance of managers. There is more management than clinicians, not sure as to why that is, though. The hospital offers so many other professionals and non-clinical staff who all work together for the patients’ good. Both organizations have policies and processes in place.
The insurance company’s goals and purpose is to do everything in their power to stand with members in sickness and health. The team members are there to learn from, support, and encourage each other. This support is via the telephone as we all work remotely from home. Working from home does create some challenges within the team. Recently, at the insurance company, a significant number of nurses have decided to leave the company due to the recent change in upper leadership. The core values are integrity, respect, commitment, excellence, and caring.
The hospital is a 302-bed acute hospital with an additional offsite emergency clinic and urgent care for non-emergencies. The hospital’s core values are safety, inclusiveness, leadership, virtue, excellence, and respect. The hospital’s culture does not alter very often; most staff and management have been there for many years with little turnover. The hospital upholds the core values of all employees regardless of the role. Each department has a manager and director; staff nurses are scheduled as charge nurse when the department manager is not there.
According to Weiss and Tappen (2015) there are a number of sources of power leaders can use; authority, reward, expertise, and coercion. Authority is the power given to an individual by an organization (Weiss & Tappen, 2015). A reward is the promise of money, expertise is the high-level knowledge of a subject, and coercion is the threat of negative consequences for non-compliance (Wallace, n.d.). Many managers and leaders often use their power to make change happen. Power can increase or decrease productivity and satisfaction in the facility. Both my direct managers are fair and treat everyone equally. I have had the experience of other managers that feel they are above everyone because of their title. This mentality usually does not sit well with nurses or the rest of the staff. Many feel they are not respected or are part of the team. Many nursing assistance and housekeepers often feel they are overworked, underappreciated, and underpaid compared to the nursing staff. It is essential nurses communicate with all staff to ensure patient safety and care. Good leadership and management skills are crucial for any successful organization.
Wallace, B. (n.d). Referent power is critical in healthcare leadership. Retrieved from https://medi-leadership.org/referent-power-critical-healthcare-leadership
Weiss, S., & Tappen, R. (2015). Essentials of nursing leadership and management (6th ed.).
F.A. Davis Company.
I’ve been with my organization for two years now and I honestly could not imagine leaving. We are a non-profit, magnet recognized hospital. The hospital stands by an acronym called “ICARE”, this stands for innovation, collaboration, accountability, respect and empathy. These are five components that the hospital revolves around. Something I truly love about my organization is that they practice what they preach. The morale in the hospital is truly incredible; it’s a very supportive and patient oriented environment. Innovation means that we always try to keep an open mind, embrace changes, take risks and maintain a creative mindset. We do these things in an attempt to improve care. Collaboration means that as a hospital we build trust and partner within our hospital and outside of the hospital. We do this in an attempt to give the best care possible and provide good outcomes. Accountability is considered the need to continue a spirit of excellence and integrity in all that we do for the patients we care for. Respect is the same as it is for anyone else, treat others the way you want to be treated. Last, empathy, which means to remain vulnerable and begin with understanding those around you so that we can meet their needs in the best way possible. I believe that due to our magnet recognized status we definitely work in an ever changing environment. The reason for this is that the hospital is constantly incorporating new practices and ACT ideas to add to nursing practice in the hospital. Every unit is responsible for coming up with new ways to improve clinical practice on their floor. I would say we definitely have a safety oriented culture. There is a lot of focus around prevention of falls and preventable errors. We have a system that we are expect to report all falls or errors in so that it can be tracked and followed up on by our chief nursing officer.
When I was reading this chapter of the book one part that really stood out to me was when it mentioned that just because you are at the top of the hierarchy and you have authority does not mean that you have all the power. I’ve really never thought of this, but it is extremely true especially in a hospital setting. One type of power it authority, this is basically defined as power that is given to a person or a group of people based on their position. Another type of power is reward; this type of power is gained by the promise of various types of benefits. The last type of power I wanted to mention is coercion; this type of power is gained by threat. Power can affect all people across all disciplines in the hospital depending on how an individual uses their power. As mentioned in the book it is important how you treat people of lesser power. For example, if you do not treat the patient care technicians fairly and they choose not to show up to work, the unit would be greatly affected. You don’t realize how much they do, until they aren’t there. People who abuse power have the potentially to negatively affect people financially, psychologically and physically.
The psychosocial care of the aging is to ensure that they find satisfaction and sense of well-being in the life later on. The aging adult is someone age 65 to the end of their life. According to Erikson’s stage of development this stage would be Ego Integrity vs Despair. The one fact that I have a hard time wrapping my head around and I realize it is true is the sexuality that is still very much active in the elderly population.
As a nurse we can influence the attitudes by pointing out that becoming older is a part of life and every human will be experiencing this cycle. The nurse needs to promote positivity when talking about the elderly population; you want to ensure that the public is aware that the elderly population is very useful and they can contribute to society. They are not to be seen as a burden to the caregiver. Would encourage the younger generation and caregivers to ask questions of the elderly population, hear their back stories of their lives; which makes them relatable. The nurse will have to explain to the caregiver regarding the changing needs of the elderly person. “Certain changes and adaptations in the forms of work ad prior learning” (Sarabia-Cob0, 2016). The caregiver needs to be aware of the real needs of support and help for the elderly.
It is imperative that a person try to understand what the elderly person went through in their life and also what they find to be of importance. Encourage healthy living lifestyle.
Sarabia-Cobo CM. (2016). Nurses attitudes to the dependent
elderly and their caregivers. Retrieved from googlescholar
After reviewing the Psychosocial Care of the Elderly source, I become especially interested in learning how stress affects the elderly. As we age, coping with stress becomes more challenging. The elderly tends to have less resilience to stress, and often find that stress affects them differently. When you were younger, your stressors may have been a busy day at the office or a crying child. Stressors are also different for the elderly than younger individuals. Stressors that tend to affect the elderly include the death of a loved one, changes in relationships, and loss of physical abilities such as vision, hearing, or mobility (Lavretsky & Newhouse, 2012). Stress has been linked to trigger multiple health conditions including cancer, Alzheimer’s disease, and arthritis (Admin, 2019).
I have heard before that older adults have died of a loneliness. Although the saying seems unrealistic, it is supported by facts. Loneliness triggered by loss of loved ones or changes in relationships can cause severe stress in the elderly. This stress can cause health conditions that might not have occurred otherwise.
Prevention and wellness are important across the lifespan, and has been a cornerstone for nursing practice. It is imperative that nurses pursue and encourage efforts at prevention and health promotion across generations.
Admin. (2019, September 10). Psychological Care of the Elderly. Retrieved November 27, 2020, from https://geriatricnursing.org/psychological-care-of-the-elderly/
Lavretsky, H., & Newhouse, P. A. (2012). Stress, Inflammation, and Aging. The American Journal of Geriatric Psychiatry, 20(9)