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Reflective Diary Table of Contents Reflective Diary 3 References 7 Reflective Diary There are differences and conflicts among the various stakeholders in the change project, all needing to be evaluated, addressed and resolved for all the parties to cooperate and for the change project in general to succeed…
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Download file to see previous pages The familiar is comfortable, even if it is not the best arrangement for all parties involved. In the field, for instance, the nurses were initially hesitant about being part of the training, and had many questions and private qualms that they shared with me. This was the reality, even as they allowed me to explain the protocol in broad strokes. The doctors, meanwhile, while generally quiet, had a stance of wait and see, and leaned on the skeptical side. The administration of the hospital too, even when they agreed to the change project, also obviously wanted to make sure that the change would result in positive changes in the unit in general, and liked that the scope of the change was limited and very specific to ankle injuries. There had to be interventions and explanations prepared for the patients as well. Underneath some of these concerns is a need to take charge and be control of the situation. The change was to unsettle them from their cozy and safe positions. The conflicts that are to come from the change in the balance of power between nurses and doctors when it comes to decision making are profound, even if they are limited to just ankle and foot injuries in the emergency setting. ...
These are seemingly benign issues, but from the perspective of who takes responsibility for patient well-being these are profound conflicts that the change project needed to properly evaluate, negotiate and resolve (Institute of Medicine, 2006). In the above evaluation conflicts it is clear too that there are dependencies in the actions and the outcomes of the actions of the various stakeholders to the change project. For instance, nurses can become empowered only with the trust and confidence given to them by the doctors, with whom the triage nurses have to work in tandem in taking care of patients with ankle injuries, making use of the Ottawa ankle rules. If doctors fail at trusting the competence of the nurses’ decisions tied to these rules, then the whole process and change project falters. Doctors will make their own decisions regardless of the nurse recommendations. On the other hand, if the nurses persist with making use of the protocol even without the cooperation of the doctors, the dependencies also break down and nurses and doctors can duplicate each others’ work. Taking a step back, the decision of the hospital administration to allow the change project to push through also cascades down the line into making all of the involved parties cooperate and see to it that their actions at least give the project a chance to make it to completion. This is so they can see whether the protocol improves their work and the patient outcomes. In the change project even the nurses were hesitant at first to make use of their new power to make recommendations on x-rays, because they knew too that the patients and the doctors depended on the accuracy of their diagnoses. On the other hand, the ...Download file to see next pagesRead More
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