The Poor Communication and Relation Between Mentors and the Student - Case Study Example

Incident report Nature/Type of Incident/Event: (Worker) Lack of support from tutor and poor communication skills Description of the incident: (Worker) One of the patients in Cubicle one was non-responsive and from the ‘look, listen, feel’ protocol learned during orientation after sounding the emergency bell, I took it upon myself to do CPR. Morgan on the entry of the cube was quick to dismiss my actions before knowing the current situation. I was intentionally left out of the clinical debrief on the patient. A brief description of injury/illness: (Worker) Stress, Work anxiety, fear Did the person receive treatment following the injury/illness? (Worker) No Person(s) who saw the Incident or first came to the scene: (Worker) Dr. Trent Michael and RN Anna Roberts were present during the CPR incident after finding the patient was not breathing. Action was taken/intended, if any, to prevent recurrence of the incident: (Manager) I propose that the preceptor or coaches be advised on how to relate with students to help them in the transition to being a registered nurse. Describe any longer-term action proposed to prevent a recurrence: (Manager) The creation of a program that ensures preceptors and students are paired concerning their characteristics and interest through questionnaires. The questionnaires would be a means of determining the best pair fit for the two parties, that is, me and my preceptor. Contributing factors: the difference in the experience of the student and the preceptor has always been an issue in communication. Were issues related to patient ID or patient factors (Manager) Not they were not. Were issues related to staffing levels, training or competency? (Manager) To some extent, it does relate to the degree of training and competence that one of our staff has had when relating to new students within medical facilities. Was equipment (or use/lack of use) a factor? (Manager) No, they were not. Was the environment a factor? (Manager) I do not think the environment was a factor because both parties have been trained to work well in medical facilities. Were appropriate policies or procedures or lack thereof a factor? (Manager) The policies and procedures set for the interaction of preceptors and students are not defined by the facility and need to be revised and updated. Was the failure of a safety mechanism or barrier designed to protect the patient/staff a factor? (Manager) No, they were not. Was communication a factor? (Manager) Communication was indeed a factor to the failure in addressing the issue between the preceptor and the student. Signed: (Worker) Date: Signed: (Manager) Date: Introduction Performance anxiety coupled with a complex situation that healthcare is usually under, generational diversity and poor communication lead to workplace conflict during the transition to practice for nursing students (Spector et al., 2015).The transition to practice for nurses is an important process of the profession where undergraduates or graduates join the Medical professional at a practical level and where they get to have a hands-on experience. Among the many objectives that the process has included growth and development of young nurses coming into practice under the regular conditions of healthcare, which in many cases is hectic (ED) (Borhani et al., 2012). The paper will debate on the poor communication and relation that the mentor and the student have, performance anxiety elevated by the complex situation (short staffed and poor skill mix) at the healthcare and finally inexperienced mentors. The paper will help to establish a process that will help deal with placement problems between a mentor and a student. A recommendation on future strategies for the student’s future practice during the transition will be enumerated to assist in the building of a healthy relationship between a mentor and a student during the transition into work nursing program. Critical Analysis of the Case Study (Shannon Doe) Shannon Doe, a third-year student, on placement at Charles Darwin University Hospital Emergency Department (ED) faces work anxiety on the first day due to the situation that the hospital was under, that is, understaffed and a poor skill mix. She is forced to orient herself to the new workplace with the help of ‘search and find.' The preceptor, even though tasking Shannon enough work for the day fails to check up on her for the rest of the first day. Day two showcases the generational diversity in the healthcare when Morgan, Shannon’s preceptor, tries to make a joke about working with Shannon but instead ends up making her feel embarrassed and which ultimately affects the student’s attitude towards her preceptor. Generational diversity in the healthcare is also shown when Morgan asks a question about a patient on answering, Shannon feels confused on the remarks made by her preceptor on her knowledge on the subject. Poor communication and lack of experience are shown by Morgan when she quickly dismisses Shannon when she was about to answer a question and instead asks her to carry out a different task. Poor communication is also showcased when Morgan quickly dismisses Shannon’s explanation on a question she had asked. On the third day lack of proper communication and poor mentorship is showcased when Shannon visits one of the patients and finds them nonresponsive. To save them from using ‘look, listen, feel’ she begins CPR after which Morgan, RN Anna Roberts, and Dr. Trent Michael arrive to find her in the process. The hectic situation at the healthcare might have been the reason for the lack of response from the emergency bell. The situation that occurred after showcases poor communication through the harsh dismissal of Shannon and the seclusion during the clinical debrief. Procedure for dealing with Problems Associated with Placement under Shannon Case Study. A solution to some of these problems involves a procedure that is necessary to ensure that the students achieve confidence, competence, and autonomy during their placement in different medical facilities. To do so, a structured approach becomes critical in developing the mentors before any interactions with the undergraduates (Gilson, 2013). A mentorship model by Morton-Cooper and Palmer, established in the year 2000, introduced a program known as mentorship model and had three phases. The starting phase of the program involves the establishment of an interpersonal relationship through effective communication skills. It ensures that the communication on issues arising in the field of nursing is addressed first hand since people’s lives are at stake (Gilson, 2013). It also ensures that the transfer of information is accurate and smooth. Moreover, it is through this stage that a student learns on how to notify authority on issues occurring during the placement. The second phase involves collaboration which builds on the cooperation between the mentor and the novice. It ensures that the learner and instructor can work together to solve an arising problem since the word emergency is a daily vocabulary for the profession. Before going to authority, a well collaborated system between the mentor and will ensure that the student finds a way to notify the mentors on issues arising to prevent further aggravation of a situation. Moreover, finally, the autonomy phase which provides the novice with more independence around the medical facility. It builds the courage of the student to face different events that take place in the hospital with competence (Gilson, 2013). Through such programs, new undergraduates in placement become more competent, create a self-awareness of the environment they are in and ensures the proper build-up of interpersonal skills among the mentors and the novice nurses (undergraduates) and their patients (Spector et al., 2015). The program also provides that the rate of student’s intent to stay and the general retention rate of new graduate increase in numbers under the profession of nursing. The profession needs more students to join to address the ever shortage of nurses in the different emergency medical facilities (Department of Labor, Bureau of Labor Statistics, 2015) and through such programs it becomes possible. Apart from mentorship programs, medical facilities that take in students for placement should implement initiatives that facilitate the proper pairing of the mentors and the undergraduates to foster growth (Spector et al., 2015). The personalities of the trainers should best match that of the student, and they should also have clinical experience that is not less than two years. A didactic nurse coaching class should be enforced to the nurses who are mentors or coaches followed by an assessment, four hours long, by their nurse manager, annual coaching update classes adding up to three and a peer assessment. All the above initiatives ensure that inexperience is dealt with and in the long run avoid problems associated with placement during the transition program for undergraduates (Zerwekh & Garneau, 2013). Recommendations for Fostering the Student's Personal and Professional Development The development of the student on a personal and professional level will require programs that will ensure they are adequately equipped with the needed skills and knowledge in nursing (Dyess & Parker, 2012). Nursing, as a profession, calls for social individuals who can communicate appropriately and more efficiently when passing on information from the patient to doctor or among other nurses. The programs should ensure that interdisciplinary communication skills are polished, extend support during the transition for specialty units, nurture leadership skills and provide strategies that allow the response of students during the transition (Zerwekh & Garneau, 2013). Interdisciplinary Communication Skills: New students, on orientation during placement should have a program that lasts at least two or more days that trains them in interpersonal communication skills. The nursing profession is one of the most common occupations that require excellent communication skills among co-workers and the patient (IOM, 2010). The training should involve role-playing where the students are helped to understand how interdisciplinary communication works and the need for quick conflict resolution in the field (Dyess & Parker, 2012). The program should be centered around simulations which exemplify and provide the students with opportunities to practice on their collegial and professional communication skills in a setting that is safe, which afterward offers to debrief on their expertise and feedback by mentors or coaches (NCSBN, 2014). Such program would help the student know how to respond to a situation or problem when it arises, and with time, it develops self-awareness and confidence which end up developing their interpersonal communication in the long run. Extend Support during Transition: Most of the programs that help nurture nurses during the transition period last for about three to six months, which at times may prove to be inadequate to develop the student professionally and personally (NCSBN, 2014). Students would benefit from support that is long-term and which includes debriefing opportunities, continued development of clinical judgment and the enhancement of their skill set (Dyess & Parker, 2012). It provides the opportunity for the students to familiarize themselves with the hospital environment. It will help combat the theoretical stage that questions the competence of the nurses in a new situation and assist them to perform better on their duties. The support of students during the transition is placed under three stages, that is, doing, knowing and being. The program should ensure that all these steps are implemented through simulations and practice. Nurture Leadership skills: The best of the way of cultivating leadership skills among student nurses is to offer them a chance to interact with mentors or coaches that are on the leaderboard (Spector et al., 2015). Students understand leadership when they have direct contact with it and experience it through conversation with the leaders. It will ensure that the student knows the job well and what is required of them in the profession. It would also encourage the students to step up personally and professionally by organizing their thoughts, emotions, and needs to achieve leadership status in different medical facilities (Gilson, 2013). It is through the experience of leadership that students can learn to be leaders through personal experience by those on top (Dyess & Parker, 2012). Apart from interaction with leaders, mentor or preceptors should create an environment that is positive for the student. Mentors or preceptors, to undergraduates, are a form of leadership and should thus be willing to help in the development and growth of the soon to be nurses. All the above strategies and program should be student centered on ensuring a smooth transition from being a student to an actual practicing nurse. Conclusion The transition to practice for a nurse is critical to the future performance of the nurses in placement and requires time and patience when nurturing the soon to be nurses. The processes and strategies discussed above ensure that issues such as communication, bullying, leadership, responsibility, and competence are developed during the transition period. Growth and development in the nursing profession require a hands-on approach, and it is during placement that the students get to have an experience. The development in the nursing practice is critical to the growth of the medical industry who are the backbone of the whole medical profession (IOM, 2010). References Anderson, B., Hair, C., & Todero, C. (2012). Nurse residency programs: An evidence- based review of theory, process, and outcomes. Journal of Professional Nursing, 28(4), 203-212. Borhani, F., Jalali, T., Abbaszadeh, A., Haghdoost, A. A., & Amiresmaili, M. (2012). Nurses' Perception of Ethical climate and job satisfaction. J Med Ethics, 5, 6. Buerhaus P. I., Auerbach D. I., Staiger D. O. (2014). The Rapid Growth of Graduates from Associate, Baccalaureate, and Graduate Programs in Nursing. Nurs-Econ ; 32(6):290-295, 311. Department of Labor, Bureau of Labor Statistics. (2015). Occupational employment statistics. Retrieved from http://www.bls.gov/oes/tables.htm Dyess, S., & Parker, C. G. (2012). Transition support for the newly licensed nurse: a programme that made a Difference. Journal of Nursing Management, 20(5), 615 623. http://dx.doi.org/10.1111/j.1365-2834.2012.01330.x Gilson RN. (2013). The Effect of a Registered Nurse Mentoring Program on Job Satisfaction and Intent to Stay in Community Health Systems Facilities [thesis]. Muncie, IN: Ball State University. Institute of Medicine [IOM]. (2010). The future of nursing: Leading change, advancing health. Washington (DC). National Council of State Boards of Nursing (NCSBN). (2014). Why transition to practice? Chicago, IL: Author. Retrieved from https://www.ncsbn.org/transition- to-practice.htm Spector, N., Blegen, M.A., Silvestre, J., Barnsteiner, J., Lynn, M.R., Ulrich, B. Alexander, M. (2015). Transition to practice study in hospital settings. Journal of Nursing Regulation, 5(4), 24-38. Zerwekh, J., & Garneau, A. Z. (2013). Nursing today: Transition and trends. Elsevier Health Sciences. Read More