Nurse II Proficiency

Nurse II Proficiency
Your Name
Subject and Section
Professor’s Name
September 7, 2023
PRACTICE:
Ms. Bridges is an exceptional healthcare professional dedicated to ensuring the safety and well-being of veterans in the domiciliary. She builds trust with everyone she interacts with, and her knowledge in assessing and evaluating specific needs is vital to delivering exceptional care. Ms. Bridges' initiative-taking approach to identifying and assessing resource utilization and safety issues is fundamental in providing outstanding care and support to veterans.
Problem:
Veteran #1 he was experiencing increased anxiety, hearing voices, and having difficulty sleeping. It is a problem when life stressors negatively impact your ability to get a good night's rest, as can poorly sleep hygiene, both can contribute to non-restorative sleep.
What was done:
Ms. Bridges assessed the veteran, checked for PRN medications, none. Contacted provider received an order for inpatient hydroxyzine 50 mg tab by mouth every six hours as needed for anxiety, contacted pharmacy to activate order to dispense via Omnicell. While waiting Ms. Bridges utilized active listening skills with veteran before administering, checked allergy profile, clarified information with veteran, and dispensed per the "5 rights". Monitored veteran for effectiveness, educated to incorporate relaxation techniques. Veteran educated to take medication as directed.
Outcome and Sustainability:
V#1 clinic visits have decreased by 90%. V#1 utilizes relaxation techniques, constructive thinking, incorporates healthy lifestyle habits, and taking medication as needed was beneficial in managing symptoms and improving overall well-being.
Veteran #1 outcome he continues to make progress in managing his anxiety and finds meaning in the resources available to him.
Ms. Bridges was recognized by Veteran #1 with a certificate for Integrity during veteran's stay in the domiciliary!,
ETHICS
Problem:
V#2 is a male who is transitioning to a female, and requested domiciliary staff address her by her female name. It appears she is experiencing gender dysphoria as evidenced by dressing as a man and as a woman. During her stay in the Dom the veteran came into the clinic to request family planning services.
What was done:
Ms. Bridges utilized resources and designed a care plan for family services. A note was placed to the provider requesting a consultation. The provider wrote the consult and urology is to schedule an appointment. V#2 continued to struggle with her identity.
Outcome:
Ms Bridges encouraged V#2 to join a transgender support group. At time of discharge, V#2 states, "I am happier, more content and have made many friends that I identify with. It has provided me with a peace of mind for my family planning needs and a future.
Statistics:
The National Center for Transgender Equality estimates there are more than 134,000 transgender veterans in America today, and another 15,000 transgender individuals serving in the armed forces.
John R. Blosnich, George R. Brown, Jillian C. Shipherd, PhD, Michael Kauth, Rebecca I. Piegari, Robert M. Bossarte, "Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care", American Journal of Public Health 103(10) (October 1, 2013): pp. e27-e32.
RESOURCE UTILIZATION
Problem:
V#1 came to the clinic seeking help with increased anxiety, hearing voices, and having difficulty sleeping. V#1 VS were noted to be elevated; PRN medication administered and monitored for effectiveness. V#1 was placed on the SBAR for 72 hours for staff monitoring. It is important to prioritize the veteran's safety and well-being in all aspects of their care. The outcome was that V#1 was in a safe and stable environment where he could express himself, utilize his PRN medications as needed and receive positive feedback.
Statistics:
Implementation of SBAR champions, teaching sessions and visual aids on the wards demonstrated the following results:
54.4% improvement in the proportion of nurses reporting using exclusively SBAR as their method of handover
100% of nursing staff were aware of SBAR (improved from a baseline of 87.5%) 44% average improvement in the self-reported perceived effectiveness of telephone handovers.
Ruhomauly, Z., Betts, K., Jayne-Coupe, K., Karanfilian, L., Szekely, M., Relwani, A.,
Mccay, J., & Jaffry, Z. (2019). Improving the quality of handover: implementing SBAR. Future healthcare journal, 6(Suppl 2), 54. https://doi.org/10.7861/futurehosp.6-2s-s54l468630050800 i i
PERFORMANCE
Problem:
There is always room for more education, as a nurse you don't stop learning, Ms.
Bridges strives to stay up to date with the latest techniques, technology, and evidence- based practices to provide exceptional care to our veterans
What was done
Ms Bridges is self-directed in educational activities whether voluntarily or mandatory to improve clinical knowledge and enhance role performance. She is 100% compliant with TMS and Elsevier modules. She is 99% compliant with monthly assessments.
Outcome:
Ms. Bridges seeks out opportunities to gain experience via Teams, Elsevier or in class instruction such as Prevention and Management of Disruptive Behavior (PMDB).
Ms. Bridges received from Veteran #1 a certificate for Integrity during this veteran's stay in the domiciliary.
Statistics:
Analysis of data from 150 VA medical centers over a three-year period revealed that facilities with stronger employee engagement had higher patient satisfaction,
better call center performance and lower turnover among registered nurses.
Boston Consulting Group. (2019, March 19). PRESCRIPTION FOR BETTER PERFORMANCE. Our Public Service. https://ourpublicservice.org/wp­ content/uploads/2019/03/BPTW18_VA-issue­ brief.pdf#:~:text=Analysis%20of%20V...