Action Research during My Clinical Placement - Essay Example

Action research Identification of the topic for intervention/enhancement After making personal and self-assessments of my actions during my clinicalplacement, I discovered that I need to increase my confidence in my interactions with my colleagues, in terms of speaking out during professional disagreements, and in helping establish solutions to problems. My confidence needs improving because noting from the reflections, my lack of confidence was flagged and identified as a problem. This was seen in my failure to express professional concerns and my reluctance to organize colleagues even when I already have the skills to carry out these tasks. In applying the team and learning theory, I was also able to establish that the above areas are issues I need to improve on and that my skills and abilities means that this area can still be improved. I was able to triangulate and evidence my proposal area through the observations made during my practice, including the observations that my colleagues were able to observe during my clinical placement. Based on the team and learning theory, I was able to deduce the importance of nurses in their roles as leaders and in gaining confidence in their role as leaders (Yates, 1996). Nurses are after all expected to be leaders in the management of health interventions (Feldman, 2008) and not being able to muster sufficient confidence in my practice would likely endanger the patient, as well as reduce my role in the health care system. As a leader however, I am expected to be a confident and assertive practitioner in relation to the other health professionals, as well as the patients (Feldman, 2008). Since, confidence is an area I need to improve on, I emphasized this aspect for my action research. I was also able to triangulate my proposal area by identifying work pride and confidence as essential elements of my practice which need improvement (Nilsson, et.al., 2005). Pride is associated with what is achieved within the work setting—working with each other and working individually. Pride also includes professional pride, as well as essential knowledge and skills and the feelings of belongingness in a certain department (Nilsson, et.al., 2005). Confidence is founded on the strong support system which exists in the workplace, from the managers and supervisors to the basic staff members. In these instances, all members of the team are there for the patients and for each other. Specific responsibilities of various departments all contribute to an individual’s or a member’s sense of belonging (Nilsson, et.al., 2005). Confidence and respect for one another is also improved as co-workers assist each other and cooperate with each other; it also improves when there is collective responsibility in prioritising and developing knowledge and skills. Furthermore, the fact that value associated with personnel categorisations is highlighted by managers, in words and in actions, appears to impact on the expressed confidence (Nilsson, et.al., 2005). The main determinants of care support the concepts of manageability and meaningfulness. These determinants applied in organizations seem to be founded on favourable work conditions, including one where the workers can confidently deliver health services. Indicative preliminary reading I was further informed by the Belbin theory of team roles in my approach and in understanding this issue in relation to my lack of confidence. This theory emphasized the need to establish balance in teams in order to establish better teams and based on various personality types are important in supporting a confident and successful team (Yates, 1996). Based on this theory, it is important for members of a team to work well with each other because there may be important issues which are at stake for the patients. A main goal of the team is on improving the life of those who need the services; therefore the team must be smoothly running in order to reduce disruption and unpleasantness for users (Yates, 1996). Members of a team all contribute their own part in the responsibilities and goals of the team. Some members team may however serve more passive roles and often allow their actions and opinions to be the same as everyone else’s. There is a risk however of these members being overshadowed by their colleagues (Feldman, 2008). Team members need to be assertive in their roles and opinions in order to ensure that patients receive the care they deserve and need. Some specific circumstances may be noticed by a particular team member and not noticed by others (Feldman, 2008). For which reason, all team members must be confident enough to express their opinions and observations, not allowing their contributions to be overshadowed by the rest of the team. Future literature I need to engage with in order to undertake this research involves readings on issues encountered by newly graduate nurses transitioning into the clinical setting. Most of the time, issues encountered relate to the lack of confidence and self-esteem regarding the nurses heavier responsibility in the patient’s care. Other literature I need to engage in would involve studies on ways by which self-confidence can be improved in practice. Literature discussing ways of improving nurse assertiveness would also need to be considered for this research. Outline of methodology In planning the enhancement of my confidence, I would carry out activities which are meant to make me more assertive and to be more expressive in my opinions and in my input involving patient care. I would also carry out the planned enhancement by gaining feedback from my fellow nurses on how well I manage to improve my assertiveness during meetings and patient conferences. I would also ask the other nurses to identify aspects of my interaction I need to improve on. I would provide a tentative list of aspects I need to improve on, and ask them to rate aspects of my assertiveness and confidence I need to improve on. The rating would range from 1 to 5 with 1 representing areas I need the least improvement on, and 5 representing the areas I need the most improvement on. In order to go about my planned enhancement of my confidence, I would also carry out a survey of the nurses, asking them to identifying recommendations on how new nurses can enhance their confidence. This survey can help formulate suggestions from experienced nurses on how they were able to gain confidence in their practice, how they were able to manage their apprehension as new nurses, and how they were finally able to become more assertiveness in their practice in relation to other nurses and health professionals. Both qualitative and quantitative survey methods could have also been employed in this research. A qualitative research could have been effective for this study as well because a more in-depth and one-on-one interview with several nurses I work with could have been easily carried out in order to meet the goals of this research (Mays, 2000). This research could easily have established various themes which I could use as tools for enhancing my confidence. A quantitative research could also have served a purpose in establishing generalizable results on possible recommendations for enhancing my confidence (Seers, 2001). The advantages of carrying out an action research are numerous. Firstly, it can contribute in professional development. Action research impacts on thinking skills, including the willingness to share and communicate (Distance Education Programme – Sarva Shiksha Abhiyan, 2007). With action research, nurses can learn about themselves, about their patients, as well as their colleagues. Secondly, action research can also assist in interactions and in the sharing of thoughts with nurses, helping each other and allowing others to present learning opportunities. These nurses can discuss their styles and share strategies and thereby increase collaboration among the departments (Distance Education Programme – Sarva Shiksha Abhiyan, 2007). Thirdly, this action research would give me a chance to reflect on my own practice, to assess myself informally and carry out investigations on the impact of my nursing on patient recovery. Lastly, action researches help improve communication between the health care team (Distance Education Programme – Sarva Shiksha Abhiyan, 2007). As my colleagues would also get involved in my action research, they can also become more flexible in their outlook of nursing practice and therefore be more open to other ideas. Disadvantages of action research include various points as well. For one, a greater time commitment is needed and this may cut into the other activities of nurses (Brown, 2002). Secondly, the issue of differences in nursing and researching may be a problem. A nurse may focus on a particular need, but the research may hamper his nursing care. In the end, both nursing and research activities may be difficult to carry out in the practical sense (Brown, 2002). Moreover, there may also be a lack of objectivity in the researcher role because the subject of the topic is also the practitioner (myself) and an unbiased assessment of data may be difficult to implement on the part of the subject-respondent. Timeline Month Activity First month Read materials on action research and issues in nursing care Second month Carry out a literature review Third month Send notices to research authorities concerned Fourth month Establish research methodology Establish questions to ask respondents Establish areas where improvements can be made on nursing confidence Fifth month Carry out interviews on staff Sixth month Participate in meetings by expressing one’s opinion and input Seventh month Assessment by staff on how one has improved in having more confidence Eighth month Collation of results/ analysis of results Ninth month Establishing conclusion. Ethical, political, organizational considerations This proposal would aid the development of practice by providing tools for improvement establishing possible recommendations for improving nurses’ confidence in relating with other health professionals and with fellow nurses. The importance of establishing and building confidence is founded on the need to establish a health organization, one which is relation-oriented and which involves active staff participation (Pelican and Lobnik, 1997). Within such organization, staff members are able to produce, to serve, to grow, and also to be assessed (Quick, et.al., 1997). In carrying out this action research, I would be able to contribute well to the organization as a whole, and the organization would also be able to serve my interests, as well as assist in my growth and development as a nurse and as a healthcare giver. This action research would also be able to aid the development of the practice by establishing recommendations for new nurses can improve their health care delivery and how they can reduce their anxiety and stress levels within the clinical setting. Health promotion is important to patients, however, it is also important to nurses and other health professionals because ultimately, it can support coherence, meaningfulness, and manageability (Nilsson, et.al., 2005). As confidence is enhanced in the workplace, I would be able to enhance the comprehensibility of my work, creating work assignments which are meaningful, socially rewarding, and stimulating. Confidence also promotes manageability as it provides access to the essential resources in managing work pressure (Nilsson, et.al., 2005). In other words, enhancing confidence can also enhance one’s resources in the workplace, also strengthening the individuals’ internal control and his ability to decide and act. In carrying out this action research with the goal of enhancing my confidence, I would also be able to increase my decision-latitude. A study by Theorell, et.al., (2001) discussed how increased decision latitude can increase morning serum cortisol, and how it can decrease staff turnover as well as decrease sick leaves (Jackson, 1983). With positive self-ratings in performance and in self-confidence, one’s risk for future illness can be reduced. Moreover, self-confidence can also be associated with work satisfaction and eventually favourable predictors of positive good health for most health professionals. Improving self-confidence also means improving job control which was identified as a mediator for improved mental health, decreased sick leaves, and better self-rated performance (Bond and Bunce, 2001). Positive impacts of this action research would likely involve relevant suggestions or recommendations from older and more experienced nurses on ways I can improve my confidence in the clinical setting. This action research would also be able to assist me in becoming more assertive during meetings and patient conferences, being confident about my opinions and decisions regarding the patient’s care. If I cannot confidently offer my opinion regarding the patient’s care, I may not be believable as a member of the health care team. On the other hand, this action research might also have negative impacts in terms of providing high standards in confidence building which I might find too overwhelming. Self-reflections as well as input from colleagues may provide a picture of the significant challenges I have yet to face. In the end, these challenges may discourage me from actually making major changes in my nursing practice. Ethical issues encountered in this research involve the close and open interaction with the individuals involved in the research process. I therefore need to make sure that the relevant individuals, committees, as well as authorities have been adequately consulted and the principles in the work are accepted by all these individuals involved ahead of time (O’Brien, 1998). The participants must also be able to impact on the work and those who do not wish to participate must not further be bothered about it. The development of the research must also be visible and open to suggestions. The permission must also be gained before observations are made (O’Brien, 1998). I also need to accept responsibility and maintain confidentiality at all times in order to protect the respondents and their opinions as well as specific contributions to the action research.   References Bond, F. and Bunce, D., 2001. : Job control mediates change in a work reorganisation intervention for stress reduction. J Occup Health Psychol, vol. 6, pp. 290-292. Brown, B., 2002. Improving Teaching Practices through Action Research. Virginia Polytechnic Institute and State University [online] Available at: http://scholar.lib.vt.edu/theses/available/etd-04152002-182022/unrestricted/BethBrownDissertation.pdf [Accessed 01 June 2012]. Distance Education Programme – Sarva Shiksha Abhiyan, 2007. Action Research (A document) [online] Available at: http://depssa.ignou.ac.in/wiki/images/5/57/Action_Research.pdf [Accessed 01 June 2012. Feldman, H., 2008. Nursing Leadership: A Concise Encyclopaedia. London: Springer. Jackson, S., 1983. Participation in decision making as a strategy for reducing job-related strain. J Appl Psychol, vol. 68, pp. 3-19 Mays, N., 2000. Assessing quality in qualitative research. BMJ, 320, pp. 50-51 Nilsson, K., Hertting, A., Petterson, I., Theorell, T., 2005. Pride and confidence at work: potential predictors of occupational health in a hospital setting. BMC Public Health, 5(92), 1471-2458 OBrien, R., 1998. Um exame da abordagem metodológica da pesquisa ação [An Overview of the Methodological Approach of Action Research]. In Richardson, R. (Ed.), Teoria e Prática da Pesquisa Ação [Theory and Practice of Action Research]. João Pessoa, Brazil: Universidade Federal da Paraíba. (English version). Pelikan, J. and Lobnig, H., 1997. Health-promoting hospitals. World Health, vol. 50, pp. 24-26. Quick, J., Camara, W., Hurrell, J., Johnson, J., and Piotrkowski, C., et.al., 1997. Introduction and historical overview. J Occup Health Psychol, vol. 2, pp. 3-6. Seers, K. and Critelton, N., 2001. Quantitative research: Designs relevant to nursing and healthcare. Journal of Research in Nursing, 6(1), pp. 487-500. Theorell, T., Emdad, R., Arnetz, B., and Weingarten, A., 2001. Employee effects of an educational program for managers at an insurance company. Psychosom Med, vol. 63, pp. 724-33. Y ates, M., 1996. Understanding Team Role Theory [online] Available at: http://executive.development.users.btopenworld.com/media/downloads/teams.pdf [Accessed 01 June 2012]. Read More