Work Setting Description
I am a nurse and I work in the cardiology department of a large hospital. The department provides care both on an inpatient and outpatient basis. It has 12 beds to serve patients with diverse cardiologic disorders. The patients and adults with conditions of the heart, arteries, and veins, or cardiovascular diseases. There are 24 nurses and 18 people employed as ancillary personnel. In addition, there are two nurse managers.
During every shift, there are 6 nurses and 4 representatives of ancillary personnel. The department is located in the main building of the hospital and occupies the whole floor. Under the cardiology department, there is an emergency care unit. Such disposition allows providing patients who address emergency care and are likely to have cardiovascular problems with quick access to the department.
Achievement of AACN Standards
A healthy work environment is crucial for a nurse. Moreover, it is interconnected with clinical excellence and optimal patient outcomes, which are important factors in health care. To establish and sustain a healthy work environment, the American Association of Critical-Care Nurses (2016) developed standards that are expected to be followed by diverse hospital departments to achieve clinical excellence and, as a result, approach optimal patient outcomes.
These standards include skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership. The department where I work complies with the majority of the mentioned standards.
Skilled communication is as important for a professional nurse as proficiency in clinical skills (American Association of Critical-Care Nurses, 2016). In my department, effective communication is one of the core priorities for all health care professionals. Much of the work related to patient care is provided in teams because patients frequently have different comorbid conditions or other chronic diseases in addition to cardiovascular problems.
The issue of effective communication is resolved by regular educational interventions aimed at the improvement of interpersonal communication skills and increase in its efficiency. When graduate nurses come to work in this department, they are accompanied by tutors selected among experienced nurses who are skilled in professional communication and can provide training for new specialists thus empowering their cooperation in teams. Communication within the department as well as in the hospital, on the whole, is characterized by tolerance and respect, which are found among nurses, ancillary staff, and other participants of interprofessional teams.
These qualities are included in the nursing curriculum and their development is continued through the period of probation and training for new nurses. The hospital on the whole and the cardiology unit, in particular, meets the standard of skilled communication because both administrators and professionals of all levels do their best to achieve agreement between actions and words, which reduces the time necessary for discussions and decision-making.
Also, for the last five years, there were no cases of disruptive behavior among the nursing staff in the work setting. One of the proofs that the standard of skilled communication is achieved in the department is the high level of information sharing among health care teams, patients, and their families. This approach significantly reduces readmission rates, which is vital for patients with cardiovascular problems.
True collaboration is one of the standards that are difficult to achieve. It is a complicated process aimed at simplification of the procedures of decision making and joint communication (Morton, 2015). Nevertheless, this standard is effectively implemented in the cardiology department. True collaboration is closely related to work culture, which is developed during the existence of the department.
According to the American Association of Critical-Care Nurses (2016), true collaboration can be successful in case such aspects as trust, skilled communication, professional knowledge, shared responsibility, respect among colleagues, and fruitful coordination are considered. In the cardiology department, collaboration is provided within health care teams to identify patient goals and select appropriate interventions. Such collaboration is crucial for cardiology patients on the whole and those who need critical care in particular.
Effective decision-making is another standard that is vital for patient care because quick and correct decisions have a direct impact on patient outcomes. The standard demands that nurses should be “valued and committed partners in making policy, directing and evaluating clinical care, and leading organizational operations” (American Association of Critical-Care Nurses, 2016, p. 21). In the department under analysis, this standard is not achieved appropriately.
Although nurses are expected to be involved in the process of making decisions about patient care, many decisions are taken by physicians. For example, while the standard suggests that nurses participate in all levels of decision making, practice shows that nursing staff is mainly involved in care decisions and cardiologists make decisions about treatment as well as about tests and examinations necessary for diagnosing.
Nevertheless, there has been a significant improvement in this aspect, and nurses are gaining a more important role in effective decision making thus approaching this standard. New administrators are interested in integrating the standards in the daily routines of the department and contribute to an increase in the accountability of nurses for effective decision making. This integration becomes possible due to the incorporation of organizational values in diverse processes running at the healthcare facility including the process of decision making. It is likely that within the following years the principle of shared accountability will be achieved at full and nurses will be involved in all organizational decisions thus enlarging their sphere of influence.
Appropriate staffing is critical for any organization and for health care facilities in particular because ineffective staffing is likely to have a negative impact on patient safety and patient outcomes. On the whole, nurses are involved in diverse stages of the staffing process. More experienced nurse professionals usually become tutors for nurse graduates who want to work at the cardiology department and evaluate the readiness of a graduate for work.
Therefore, staffing in the department is likely to be effective because it allows assessing if nurses’ competencies are adequate to meet the needs of patients in the cardiology department. The staffing of the department can be considered adequate. During every shift, the nurse-to-patient ratio is 1:2, which is enough for the cardiology department where every patient may need emergency care.
Still, there is a general lack of nurse professionals to provide adequate scheduling and allow nurses to work shorter shifts to reduce the risk of fatigue and burnout thus contributing to better patient outcomes. Moreover, in case of illness of one or more staff members or when an employee leaves work, there are problems with providing shift staffing. At the same time, the hospital has an effective support service for nurses, which can be addressed in case a nurse has problems in the department. Also, if there is a need to use it over time, it is paid appropriately.
Meaningful recognition is one more standard to be discussed. It implies recognition of the contribution made by every individual to the process of care and the work of health care facilities on the whole. The provision of recognition demands the involvement of both hospital and department administration and leaders to develop the procedure of recognition. In the cardiology department under consideration, recognition is provided for both interprofessional teams and individuals.
The hospital has developed a recognition program, which provides health care professionals who contribute most to patient wellbeing with certain rewards. There are some alternatives that are selected by the appointed commission such as promotion, financial award, or provision of educational opportunities. For example, a nurse can be suggested to join a program to improve professional skills at the cost of a health care facility or be promoted to a managerial position.
Authentic leadership is the last standard on the list but it is frequently decisive for a healthy work environment. Nurse leaders are responsible for a variety of functions critical for the successful functioning of the department. For example, in the cardiology department, nurse leaders are expected to monitor staff behavior and work satisfaction not to allow burnout and achieve a high rate of retention. The nurse leader at the department follows the style of strategic leadership, which is commonly effective.
This person is aware of the department’s needs including the needs of patients and organizes its work to achieve both patient and staff satisfaction. at the same time, my supervisor is a charismatic leader, who manages to transform our values and the attitude to nursing as a profession. This person is engaged in what she does and is an effective motivator. Moreover, it should be mentioned that individual nurses also act as leaders in communication with patients and their families including the process of patient education. On the whole, nurse leaders in the work setting display mainly expert power, which is one of the most effective powers. Demonstration of expertise in the professional sphere provides nursing staff with both an example to follow and motivation to achieve excellence.
Summary Evaluation
To summarizing, it can be mentioned that my work setting is a generally healthy work environment. Still, it has both strengths and some areas to be improved. The major strength is that the cardiology department under analysis follows the majority of standards that are necessary for establishing and sustaining healthy work environments. Another strong point of the department is that it closely approaches the standards of skilled communication and true collaboration. One more strength is the attention of the department leaders to the issue of meaningful recognition, which allows keeping the nursing staff motivated. Finally, leadership styles such as strategic and charismatic, also make a strength of the department.
As for the areas that need improvement, they are the approach to decision making and staffing policies. Thus, effective decision-making as a standard needs more involvement of nurses in the process of making clinical decisions. Also, it is important to evaluate the staffing policies and provide the department with enough qualified employees able to perform their professional duties. Still, the environment of the work setting is healthy and contributes to both professional growth and motivation to constant self-development and continuous education of nurse professionals. It is achieved due to approaching the accepted standards that are leading to excellence in patient care.
References
American Association of Critical-Care Nurses. (2016). AACN standards for establishing and sustaining healthy work environments. A journey to excellence (2 nds. ed.). Aliso Viejo, CA: American Association of Critical-Care Nurses.
Morton, P. G. (2015). Creating and sustaining healthy work environments. Journal of Professional Nursing, 31(3), 165-167. Web.