Extraordinary Nurses and Extraordinary Deeds. Management

Extraordinary Nurses and Extraordinary Deeds
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Extraordinary Nurses and Extraordinary Deeds
Nurses require multiple attributes to perform exemplarily in their dynamic clinical settings. A nurse is expected to manage the psychological and operational vigor by which the clinical setting is characterized. In practice, nurses have the skills and knowledge to execute their duties. Important of such areas of knowledge are nursing ethics. Besides, there are standards from professional organizations and regulatory agencies that define the boundaries of operations. However, even with the skills, knowledge, and standards, nurses are still susceptible to errors. Some of such errors occur as a result of mistakes triggered by the characteristics of the operational environment while others emanate as a result of ignorance or lack of adherence to particulars standards. The concept of extraordinary nurses and extraordinary deeds in extraordinary settings is a description of the additional roles or attitudes that could land nurses into known or unpredictable mistakes in normal operational settings. Various pieces of literature have been published to explore the topic with most of such works embedded in what could trigger nurses into unknown or avoidable errors and the impacts of such occurrences to the profession. It is agreeable that not all nurses intend to harm their patients. Also, there are multiple contributors that must be considered to the prospect. It is, hence, unfair to generalize the assertion that all nurses are susceptible to executing harm to their patients.
Background Information
Error is an inevitable aspect in healthcare and people must acknowledge that they cannot be prevented absolutely in healthcare organizations. However, when the national statistics related to a particular aspect of errors exceed the limits, people must ask questions. In the recent past, errors committed by nurses became subjects of debate. That is considering the fact that in the US, nurses are responsible for approximately 750,000 errors annually (Brauner et al., 2018). The mortality rate arising from such errors has stood at between 44,000 and 90,000 annually. The data imply that in every 300 errors committed by nurses, there is one death. To put the analysis in context, road accidents only kill 43,000 Americans annually while the mortality rate of breast cancer is 40,000. Also, the mortality rate of AIDS is 17,000 (Marselas, 2018). Hence, errors emanating from nurses lead to mortality rates that eclipse some of the leading causes of death in the nation. That begs the question of why such occurrences exist. To people who have only assessed the problem superficially, the problem lies with the nurses. In fact, some analysts believe that nurses commit errors intentionally (Toles, Young, & Ouslander, 2013). Questions are still raised on whether trained professionals such as nurses could commit intentional errors knowing that such behaviors defy the principles of the profession.
Review of the Literature
Various studies have been conducted to explore the extent of extraordinary activities among nurses and the impacts of such activities. Monumental among the prospects is the extraordinary role described as double duty in healthcare. In their research, DePasquale et al., (2016) insist that nurses are occasionally indulged in performing beyond their roles and abilities because they desire to help. Double duty care refers to an individual who is involved in both formal and informal care. The types can be double-duty childcare, double-duty elder care, or triple-duty of an adult and childcare. Such nurses have divided attention in their roles. That is, they have to attend to their formal operational settings just as much as they attend to the informal obligations. In the long-term, the impacts could be detrimental.
There are psychological impacts associated with the indulgence on double duties for healthcare practitioners. In their study that accommodated 1,399 participants, DePasquale et al., (2016) noted that nurses who are involved in double duties rank higher in family-to-work conflicts. Such nurses are known to showcase divided attention in their roles and normally wander between what bears the highest benefits. Some of the symptoms of enhanced indulgence in double duties are psychosocial impairment. Such practitioners barely have the opportunity to interact with other people besides their care settings. In practice, psychosocial deficiencies can culminate in poor interactions between a practitioner and a patient (Pozgar, 2012). The current safety standards and patient-centered care demand that a practitioner must interact with his/her patients and deliver results according to the needs of such patients. The moment a practitioner’s social or psychological abilities are compromised, they are likely to initiate care according to what they believe is right and not what the standards require. DePasquale et al., (2016) employ a covariance test to conclude that nurses must find strategies to balance their formal and informal roles. Failure to instill the changes is likely to engineer stress and dislike for the operational environment, which are principal causes of the extraordinary deeds leading to patient safety concerns.
Nurses also perform in the confines of duty of care that could sway their deeds. A nurse has both legal and professional duty of care. In the legal confines, the law imposes a duty of care on professionals in healthcare in situations where the law sees a reasonable chance that the practitioner could potentially cause harm to the patient. The harm could arise either from commissions or omissions. The legal duty of care applies to all professionals regardless of their specializations. This law is provoked when the practitioner has assumed some sort of responsibility to care for a patient. The law regards these inputs in complex procedures or basic personal care. One area that such extraordinary deeds occur often is during accidents. With their knowledge and skills, healthcare professionals normally feel the obligation to provide care. Members of the public who surround areas where accidents have occurred normally expect nurses to have some basic skills in healthcare aspects such as light surgeries or first aid. Unfortunately, some practitioners do not have the skills exclusively. In their attempt to provoke the legal duty of care, such professionals are rendered likely to cause harm.
The law extends to describe the possibility of negligence while a practitioner provokes his/her legal duty of care. In performing any extraordinary duty, a nurse is obliged to adhere to the standards pertaining to that specific care. It is, for instance, highly risky for a nurse to conduct a surgery where there is no equipment in the belief of provoking the legal duty of care. The moment a practitioner limits his/her roles to their own knowledge and with a notable disregard to standards, that practitioner is effectively considered negligent (Lewis, 2019). Attributing liability to harm that happens to a patient stems from examining the responsible individual. The execution of the roles whether within the confines of the standards or not should redefine who takes responsibility for the harm caused. It is worth remarking that indulgence into extraordinary deeds escalates with the fact that personal attributes such as experience do not count when provoking the law (Williamson, 2015). An inexperienced nurse would be expected to perform similar duties as his/her experienced counterparts when the legal duty of care is provoked.
The legal duty of extends to the professional duty of care. Nurses are trained to perform some duties that limit harm to the members of the public. In every situation, nurses must feel the obligation to address the issues (Lewis, 2019). NMC code and related NMC operational standards and guidelines dictate that a nurse should be ready to discharge his/her professional obligations notwithstanding the situation. Failure to execute such duties amount to the breach of the codes and could be liable for legal consequences. Such codes motivate nurses to participate in extraordinary deeds. Evidently, the codes are not flexible enough to define qualifications, skills, and knowledge that can impact the outcomes of a clinical duty adversely.
The operational environment also plays a vital role in the perception that particular operational environments play on safety. The operational environment is the clinical setting in healthcare. A clinical setting is a space with structures and people. The interactions between the structures and the people could affect a practitioner’s adherence to patient safety obligations in one way or another (Espinoza, 2016). Take for instance a healthcare facility whose clinical environment is not organized and has obstacles. Practitioners understand that such an environment could cause harm. However, they could choose to ignore reorganization if nobody supports the efforts. To inhibit nurses from making avoidable mistakes, managers in healthcare facilities have the obligation to make the operational environments as serene as possible. Modern healthcare facilities employ motion sensors, for instance, to eliminate obstacles. Such moves encourage nurses to adhere to particular standards and avoid errors naturally. This assertion does not underlie the fact that nurses should identify any obstacles, holes, or poorly lit rooms in their operational environment. It only insists that bearing the fatigue and multiplicity of duties that nurses currently face, they may need technological inputs in the operational/clinical settings to avoid some common mistakes.
Patient safety is an aspect of culture that people follow according to their dominance. In an analysis of behavioral integrity for safety and priority of safety, Leroy et al., (2012) noted that the dominant culture plays an integral role. The researchers conducted a path modeling survey to determine the perceptions that people have about patient safety in healthcare settings. Employed 54 nursing teams to arrive at their conclusions. The cultural behaviors and perceptions that nurse leaders have about patient safety impact the perception of their patients. The results of the study indicated that nurses are psychologically prepared to adhere to standards if their leaders demand adherence. Put simply, a healthcare facility that has a culture with limited emphasis on patient safety is highly likely to sway nurses into errors. One aspect of organizational culture that could limit safety concerns is communication (Field, 2010). Enhanced communication between nurse leaders and the younger nurses should come with positive outcomes on commission or omission of responsibilities. Nurse leaders or ...