NURS 3375 Reflective Journal Template-updated

NURS 3375 Reflective Journal Template-updated. N3375 Health Policy & Legal Aspects Reflective Journal Name: Date: 11/17/2018 Overview: Reflective Journal Each week you will make an entry into your Journal. You are asked to reflect on 3 key points for each module (Modules 2-5). Key points: What did you take away from the module knowledge wise or interesting? Each entry should reflect on your understanding of the topic, your experiences and observations in your work environment or general nursing environment regarding the module topic. This is a cumulative document. You will save it to your own computer desktop or memory device and update it each week. You will upload and submit the latest version of your Health Policy & Legal Aspects Reflective Journal to Blackboard by 2359 the Saturday following each class of this course. Your entries will be graded using the journal rubric; please be sure to follow all instructions. Rubrics: Use this rubric to guide your Journal entries. There will be total of 4 Journal entries (Modules 2, 3, 4 & 5). With each journal, you are ex- pected to address 3 key points from the class lecture, discussion, and content. Discuss how each point applies to your practice as a nurse, and, finally, how will your practice change in the future because of this information. Each response to every question must be at least 3-4 well written sentences using critical thinking. No partial credit. Follow the example. Do not be shocked when you receive minimal credit on this assignment because you did not read and follow this statement!!! Journal Rubric for each Module Criteria Target Unacceptable 1st Key Point (30 Points) Discuss 1st key point and why it Does not sufficiently record con- is important or memorable. nections or reflections. Fails to Connect RN-BSN experiences to connect RN-BSN experiences to key point (career goals, prior goals, prior nursing practice, nursing practice, a previous RN coursework, theories or research BSN course, nursing theories or to key areas addressed. Fails to research). Describes how per- describe how personal practice sonal practice will be different in will be different in the future the future based on RN-BSN based on RN-BSN program. program as a result of the key point addressed. Must be at least 3-4 well written sentences using critical thinking (for (0 Points) each question). No partial credit. (30 Points) 2nd Key Point (30 Points) Discuss 2nd key point and why it is important or memorable. Connect RN-BSN experiences to key point (career goals, prior nursing practice, a previous RN BSN course, nursing theories or research). Describes how per- sonal practice will be different in the future based on RN-BSN program as a result of the key point addressed. Must be at least 3-4 well written sentences using critical thinking (for each question). No partial credit. (30 Points) Does not sufficiently record con- nections or reflections. Fails to connect RN-BSN experiences to goals, prior nursing practice, coursework, theories or research to key areas addressed. Fails to describe how personal practice will be different in the future based on RN-BSN program. (0 points) 3rd Key Point (30 Points) Discuss 3rd key point and why it is important or memorable. Connect RN-BSN experiences to key point (career goals, prior nursing practice, a previous RN BSN course, nursing theories or Does not sufficiently record con- nections or reflections. Fails to connect RN-BSN experiences to goals, prior nursing practice, coursework, theories or research to key areas addressed. Fails to research). Describes how per- sonal practice will be different in the future based on RN-BSN program as a result of the key point addressed. Must be at least 3-4 well written sentences using critical thinking (for each question). No partial credit. (30 Points) describe how personal practice will be different in the future based on RN-BSN program. (0 points) Spelling & Grammar (10 points) 3 or less spelling & grammar er- rors in the reflective journal. Greater than 3 spelling & gram- mar errors in the reflective jour- nal. (10 Points) (0 Points) Instructions: Each week, record your experiences, connections to your course goals, and reflections as they relate to the given prompts and/or your course project. You will come up with 3 key points from each Module and then follow the instructions listed below. For privacy, refer to patients, online colleagues, and/or co-workers with initials instead of names. Save this document to your own computer desktop or storage device after each entry to create a cumulative journal. Journal Entries A separate Journal entry is required for each class by 2359 Saturday of each indicated class. Provide details of your thinking, including insights, challenges, paradigm shifts, and goals. Identify previous course topics, readings, or research that relate to the prompt. Journal Entry Reflective Journal Example: Identify 3 key points from this module. Reflect on why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Place Key Point in this column: Reflect on the Key Point (following Journal Rubric) in this column: YOU MUST ANSWER ALL 3 QUESTIONS ABOUT YOUR KEY POINT IN ORDER TO RECEIVE CREDIT (NO PARTIAL CREDIT). PLEASE COME UP WITH YOUR OWN KEY POINTS FOR EACH MODULE. DELEGATION, SAFE HARBOR & PEER REVIEW ARE JUST EXAMPLES- PLEASE COME UP WITH YOUR OWN KEY POINTS FOR EACH MODULE. Do not write in this example box. Please place each Module in its designated box. Scroll down and type your Module 2 journal in the Module 2 box and do the same for subsequent journals. Key Point 1: 1. Why it is important? at least 3-4 well written sentences using critical thinking 2. How does it impact my work/nursing practice? at least 3-4 well written sentences using critical thinking 3. How will I change my practice? at least 3-4 well written sentences using critical thinking Example: Delegation Key Point 2: 1. Why it is important? at least 3-4 well written sentences using critical thinking 2. How does it impact my work/nursing practice? at least 3-4 well written sentences using critical thinking 3. How will I change my practice? at least 3-4 well written sentences using critical thinking Example: Safe Harbor Key Point 3: Example: Peer Review 1. Why it is important? at least 3-4 well written sentences using critical thinking 2. How does it impact my work/nursing practice? at least 3-4 well written sentences using critical thinking 3. How will I change my practice? at least 3-4 well written sentences using critical thinking Reflective Journal Module 2: Legal Overview and Peer Review Process: Identify 3 key points from this module. Reflect on why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Place Key Point in this column: Answer each question below with at least 3-4 well written sentences using critical thinking. Key Point 1: Standards of Nursing Practice 1. Why it is important? The Standards of Nursing practice is important due to it is the very core of what is expected of us as nurses. It directs us in what is the minimum acceptable level of care in each setting to ensure patient safety. This is what sets us apart from non-licensed practioners. 2. How does it impact my work/nursing practice? It impacts my work due to my foremost priority is to ensure my patient safety. I continuously ensure protect my patients’ privacy, treatments, reporting and myself with proper documentation and continuing gain knowledge on advancing treatments, medications and proper care for my patients. 3. How will I change my practice? I will continue to learn as much as I can, so I can improve my nursing skills. I will apply my growing knowledge and my experiences to provide the best care to my patients. I will also use this to help other nurses, even though we have a standard level of acceptable care, we should always strive to provide more than standard care. Key Point 2: Mandatory Report by the Nurse 1. Why it is important? Mandatory Report by the nurse is important due to we have a duty to ensure patient safety, not only from our own nursing care, but also from our colleagues. We must always remember that patient lives depend on us, just as our lives can depend on nurses who are not qualified. 2. How does it impact my work/nursing practice? I am a hospice nurse, and have an autonomous role visiting patients in their homes. The patients give me their trust, and I must ensure that I am able to perform my duty to the best of my ability. As I also must ensure that my colleagues perform their duty to the best of their ability. 3. How will I change my practice? At times I feel that I have an obligation to help out nurses when I know the best care was not given, but I must remember that my true obligation is to our patients. They trust me and I must always remember that their safety is my first obligation. Key Point 3: Unprofessi onal Conduct 1. Why it is important? The unprofessional conduct rules protect clients from incompetent or illegal conduct of licensees. This can involve deceit, fraud or injury to a patient, even if an actual injury did not occur. (n.d.). Retrieved November 17, 2018, from 2. How does it impact my work/nursing practice? As a hospice nurse with an autonomous role, we go into patients’ home and gain their trust. This is something that nurses can take advantage of and possibly defraud patients. 3. How will I change my practice? Due to that we care for patients at the most vulnerable time of their life when they are dying, this makes them more susceptible to easily be taken advantage of. This will make me more aware that I must always patient and the public from unethical conduct. Reflective Journal Module 3: More Peer-Review Laws and Rules: Identify 3 key points from this module. Reflect on why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Place Key Point in this column: Answer each question below with at least 3-4 well written sentences using critical thinking. Key Point 1. Minor Incident 1. Why it is important? This rule defines what conduct performed by the nurse may be considered a violation of the Texas Nursing Practice Act. This rule may help with the decision if the nurse poses a future threat to patients. 2. How does it impact my work/nursing practice? I work in a home- health setting that has an autonomous role and at times if an error is made by the nurse it may be difficult to find out about it. When errors do 3. happen, we find out from a combination of the family or the nurse reporting his/her own error. The rules give us a matrix how to go about determining if the incident is reportable or not. 4. How will I change my practice? This will impact my practice due to as a manager, I am able to look at the rules or minor incident rules to get a better understanding if an error is reportable or not. Key Point 2 Whistle- blower Protection 1. Why it is important? This is important because it ensures protection for nurses to witness patient violation and not to be afraid to report the violations for fear of retaliation. 2. How does it impact my work/nursing practice? This impacts my nursing practice due to I will not be afraid to report anything that violates the Nursing Practice Act or puts patients or the public in danger or potential harm. 3. How will I change my practice? I will continue to make the safety of patients and the public a priority, and knowing I will have protection retaliation, I will not be afraid to report any potential or actual violations. Key Point 3. Incident – Bases Peer Review 1. Why it is important? It is important due to it gives the committee the opportunity to review the incident or error, review all the facts and determine if the incident is reportable to the Texas BON. It also gives the nurse the opportunity to present any facts or witnesses in regards to the incident. 2. How does it impact my work/nursing practice? This impact my work due to the decision of reporting a nurse or not to the board, does not lay solely on me as the manager. Patient and public safety is my priority, and nursing errors or incidents are reviewed by the committee based on the rules. 3. How will I change my practice? Patient and public safety will continue to be my priority, I will continue to look to the Texas BON for guidance to ensure patient and public safety. This will also help me to grow stronger in my nursing legal knowledge so I may guide my colleagues. This has also given me the knowledge on the steps needed to be taken if a colleague or myself are ever peer-reviewed. Reflective Journal Module 4: Professional Boundaries and Challenges: Identify 3 key points from this module. Reflect on why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Place Key Point in this column: Answer each question below with at least 3-4 well written sentences using critical thinking. Key Point 1. Boundaries and Social Media 1. Why it is important? Nurses help patients in some of the most vulnerable times of their lives, and at times forms a bond of trust. The nurse may also have access to patient’s sensitive information. The nurse must always be a patient advocate acting in the patient’s best interests, while respecting the patient’s privacy and dignity. A nurse must always maintain professional boundaries, so the nurse-patient therapeutic relationship will not be jeopardized. 2. How does it impact my work/nursing practice? I work in hospice which is an autonomous role, and many times, the nurse, patient and family form a bond. That bond may be confused and break the role of professional boundaries, especially with social media. A simple Facebook post can easily violate HIPPA. It is important that we maintain those professional boundaries, so we maintain trust and respect. 3. How will I change my practice? With Social Media on the rise, I will continue to ensure all patients privacy and dignity. It is not place as nurses to discuss sensitive issues regarding patients’ illnesses, lives or families on social media. I will continue to educate nurses and myself on how to maintain professional boundaries, despite forming bonds with patients and families and how social media can break trust, even if not meant in a harmful way. Key Point 2 Nursing Fatigue 1. Why it is important? Fatigue affects any person emotionally, mentally and physically. It is especially important to address fatigue among nurses due to nurses are taking care of other lives. Fatigue can affect a nurse’s assessment, judgement, slowed reaction time, medication administration, order implementation and / or procedure implementation, which can increase risk for harm for patients. 2. How does it impact my work/nursing practice? Working in a home hospice setting with an autonomous role, nurse fatigue can have a detrimental effect on patients. We deal with high narcotic dosages, and patients that have a terminal disease. We do not have a floor supervisor that is just down the hall that we can call for help. We must always be alert due to a dying patient’s symptoms will not always be clear cut. We must be able to critically think, and have a clear mind to ensure patient safety. 3. How will I change my practice? I hold meditation sessions biweekly to assist with nurse fatigue, times I feel the sessions are not enough. I will also look to implement patient case load restriction and on-call days restriction. This will improve quality of visits and complete documentation between work hours of 8a-5p without having to document at night. Key Point 3 TPAPN 1. Why it is important? Nurses have access to narcotics that have a high risk for addition. When a nurse has a chemical impairment, it will alter his/her judgement, decision making, critical thinking and, (but not limited to) assessment skills. This impairment is unsafe and will place patients’ lives at risk 2. How does it impact my work/nursing practice? I work in hospice in which we care for patients in their homes. Many times, the patients are prescribed narcotics that are managed the visiting nurse. This poses a temptation for nurses who have chemical dependency issues, due to how easy it is to take the medications. We have measures in place such as limited refill dates and lock boxes with narcotic count sheets, but unfortunately, the count can be falsified. 3. How will I change my practice? I will look for signs of possible dependency such as; the same nurse asking for early narcotic refills, continuously asking to increase the patient’s dosage, requesting to be the pharmacy runner to deliver the medications. Assess a nurse’s behavioral patterns and random drug test. Our goal to ensure nurses a not impaired to perform their job duties, and ensue patient/ public safety. and if dependency is suspected and proven, get the nurse the help that is needed. Reflective Journal Module 5: Malpractice: Identify 3 key points from this module. Reflect on why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Place Key Point in this Answer each question below with at least 3-4 well written sentences using critical thinking. column: Key Point 1 Duty to the patient 1. Why it is important? When a nurse accepts a patient assignment, the nurse owes the patient a duty to ensure the best care. But even if the patient is not assigned to the nurse, he/she has an independent duty to the patient to provide minimally safe nursing care. As described in the Nurse Lunsford’s case, the nursing license belongs only to the nurse that holds it 24/7. 2. How does it impact my work/nursing practice? I work with hospice patients in their home. At a patient’s home, her son described his chest pains that were classic symptoms to an impending heart attack, and I could clearly see he did not look good. I called 911 and took care of him until he was taken away by EMT. Even though his mother was my patient, I know I had an independent duty to him. Unfortunately, he died a few days later in the hospital, but I know I took the appropriate action to help him. 3. How will I change my practice? Because of working with patients in their homes, I often times hear nurses say “that is not my patient I am not helping”. I will instruct on independent duty, and the nursing license is owned by the nurse 24/7. We are responsibility to provide minimally safe nursing care, regardless of any relationship between the patient and the nurse. Key Point 2 Mal- practice 1. Why it is important? Many times, I hear people speak about their hospital experience, and someone usually says “you should sue the hospital, nurses and the doctors for a lot of money”. It seems in the world we live, that suing is what always comes to mind, but for a lawsuit to ensure the 4 Elements of malpractice must be present. 2. How does it impact my work/nursing practice? Even working in hospice with patients that are terminal an expected to die, frequently we are threatened to be sued. Ex a spouse of a patient, “the hospital messed up and sent her to you and now you tell me she is dying, if you give her that pain medication and she dies, I will sue you”. The patient had breast cancer coming out of her breast and was yelling in pain. I understand he was grieving, but when he said the words it did put me on edge. I spoke to him calmly and he agreed to the medication for his wife’s’ comfort, but in the back of my mind, I was just thinking of being sued. 3. How will I change my practice? Knowing the elements that need to be present for a malpractice, has increased the knowledge of my responsibility. Instructing on duty to the patient, (even independent duty), breach of duty, injury to the patient and the nurse’s action. Instructing my fellow nurses that our duty is to always provide minimally safe care, regardless of our setting. Key Point 3 Protection 1. Why it is important? The Board of Nursing has implemented protections that a nurse can take advantage of to decrease our risk of being involved in a license investigation or malpractice. The Board of nursing priority is to ensure safety of the public, and is always helping us how to always protect ourselves, and how we can remain competent nurses. 2. How does it impact my work/nursing practice? At my job, we have continuing education courses that are assigned to us on a monthly basis. We continuously have in-services on proper documentation, as I feel this is the number one way a nurse can protect his/her self. As the saying goes, if you did not document, it did not happen. Also, carrying professional liability insurance is always advised. We must now how to protect ourselves for the possibility of a lawsuit. 3. How will I change my practice? I will continue to instruct on proper documentation and the importance to be compliant with continuing education. The one thing I will look in to heavily is obtaining professional liability. I am aware now that my company attorneys will not look out for me individually, and I must have my own protection and an attorney who will represent just me and my best interest.