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Managing
Change 10%
- Weeks 5 and 6 (24-30 Sep,
& 1-7 Oct) There are
three Assignments in Unit
Three.
All
must be completed and posted by midnight, Sunday,
of Week 6 of the course. Use the forum in
WebCT for Questions
for Instructor on Unit
3 to
ask me questions about anything in Unit
3. Use the forum for
Student
Resources
to post URLs to
links of interest to the entire
class. Post suggestions
about the way the course works in the
Suggestion
Box. Use the
Student
Lounge to
talk about whatever you like; it isn't
course-related. (The following notes were
authored by Prof. Carol Smith, PhD, RN, University
of Kansas Medical Center, School of Nursing. They
are used her with her
permission.) A demanding job description
has always been part of our work in
nursing. Many nurses have been
personally affected by recent changes in the
environment of health care. We seem to have fewer
and fewer resources to care for patients and
families with increasing severity of
need. Biotechnology is expanding so
rapidly that we have experienced dramatic changes
in clinical treatments and the disappearance of
whole groups of in-patients to a variety of
ambulatory services. We are a part of a national
health care system believed by the public to be
inefficient, overly expensive and unavailable to
many Americans. When any environment changes
so rapidly, it is difficult to feel secure in our
work. It is difficult to feel confident that our
knowledge base will be sufficient to meet the
demands for new and better approaches to patient
care. When we are busy and stressed by the
environment that surrounds us, it is a personal
challenge to be "caring" - the very essence of what
nursing is all about and what our patients and
families need the most. Despite the difficulties
inherent in the rapid race of change, we must work
together. There are five imperatives for nursing's
future: 1. Nurses must be a strong
voice in national and state health legislation.
Nurses have long supported efforts to create a
health care system that delivers affordable,
quality care services to all people in need. While
future health legislation is expected to be
complex, no matter what specific initiatives are
enacted, nurses can help support a restructured
system that enhances consumer access to
cost-effective primary health care in
community-based settings. 2. Nurses must be accountable
for clinical outcomes along with physicians and
other care givers. Throughout clinical research and
program evaluation, we can show evidence of
nursing's contribution to the health and well-being
of our patients. Through planning and careful
monitoring, we can make improvements in the quality
of nursing services we provide. Nurses must be able
to identify the most cost-effective ways to deliver
care. In doing so, we can help shape a system that
benefits public health and maximizes our health
care dollars. 3. Nurses must design new
systems for care delivery that ensure access for
all to quality, cost-effective health care
services. The care continuum is changing. Nurses
see changes in the needs of patients and families
that suggest the need for redesign of our care
modalities. Patient-centered care places patients'
needs before care giver convenience. Alternative
care settings, new technologies, creative models of
care delivery and collaborative work teams that can
demonstrate their effectiveness are the hallmarks
of successful transition to the future. 4. Nursing education must be
designed to meet the changing needs. Traditional
teaching methods will need to be replaced with
non-traditional clinical practice sites and
interactive information exchange and learning
technologies. Increasing numbers of advanced
practice nurses will need graduate education.
Support must be provided for APN (Advanced Practice
Nurse) roles in a variety of primary care, case
management and mental health services in a
continuum of care giver services. Nurses must be
leaders in collaborative efforts with physicians
and others in creating systems to meet the needs
for universal access to health care for a diverse,
multi-cultural population. Practicing nurses must
recognize their influence on students and faculty
and their obligation to help share nursing
education. We must encourage the efforts of new
graduates to practice nursing differently and to
develop different care systems. 5. Nurses must participate in
world health initiatives. Nurses can support
world-wide efforts to improve the health of publics
in need. We can learn from the experiences of other
nurses and health care systems. Many of us are
directly involved with health caring activities in
foreign countries. All of us can applaud these
efforts, opening our hearts and minds to new ideas
generated by diversity among nurses. We must ensure
our place in the continuum of health care services
by taking actions to address these imperatives for
the future of nursing. We have very little time to
mourn the loss of the health care system of the
past. Nurses must take action now to seize the
opportunities of our future. Assignment
3A: Nursing in the 21st Century Read: Armed with your
baccalaureate degree, you will be expected to take
a leadership role in effecting change wherever you
are. You may well be perceived as a radical by
those who want to maintain the status
quo. What are your rules for
taking a leadership role in making change happen in
your professional environment? What are YOUR "Rules
for Radicals"? For example, here
are mine: 1. You can't make
a difference without doing things
differently. That means
applying pressure to move faster, more
efficiently, more effectively. But
someone's toes are going to feel the
pinch. If someone's not complaining
about the way we're doing things, we're
not doing our job! 2. Think fast --
then act fast. One of the
toughest adjustments for people from
the old way of doing things is to keep
up with the pace of the new way. "Don't
just walk the talk; RUN the talk!" We
used to think that the half life of
knowledge is 5 years. Now it's 5
months. 3. Fight for
change, but pick your battles
wisely. Change agents
always meet resistance. The tough
question to answer: Which forms of
resistance deserve attention? "If the
brightness on your screen is always at
full intensity, you can't tell what's
highlighted." 4. Never
compromise the truth -- but modify your
style. There's more than
one way to tell it like it is.
"Sometimes you break glass; sometimes
you bend it; sometimes you leave it the
way it is and look through
it." Assignment: Use the forum for
Assignment
3A
(Nursing 21st Century)
to post four of your own "rules for radicals" to
guide the process of change in your nursing
environment. For each rule, write a short, pithy
explanation. Read each other's rules and
discuss. Raise questions; ask for clarification;
probe; make suggestions. See if you can add rules
to the lists of others. Read each other's rules and
discuss in Assignment
3A
(Nursing 21st Century).
Raise questions; ask for clarification; probe; make
suggestions. See if you can add rules to the lists
of others. Assignment
3B: Managing Complex Change The single most important
thing a nursing student in today's world can learn
is how to manage complex change. You can be
expertly adept at managing all the latest whiz-bang
gadgetry in a critical care unit, but if you can't
handle the stress of change, or don't know how to
manage change in your life and in the environment,
you won't be a good nurse. In the chart below, the top
row of elements are the critical elements required
to manage complex change. Read across each row of
elements to see how a lack of one critical element
results in confusion, anxiety, and treadmill
repetitiveness. Your assignment is to write a
one-to-four paragraph essay that describes a
real-life situation that you've experienced
regarding change when one of the critical elements
was missing. What problems occurred in that
situation? Were the problems resolved, and if so,
how? Post your essay in the forum for
Assignment
3B
(Complex Change). Read each other's essays in
Assignment
3B
(Complex Change).
Comment as the spirit moves you. + + + + = Change + + + = Confusion + + + = Anxiety + + + = Resistance + + + = Frustration + + + = Treadmill Assignment
3C: Developing Skills for Managed
Care Assess your own skill levels
by reading and considering the "Skills for
Clinicians in Today's Managed Care Marketplace"
(below). After considering your own
skills in light of the list of skills below,
imagine yourself starting a new job in a managed
care setting. Put yourself in the shoes of the
manager of this clinic who will need to orient you.
Devise a detailed plan that this manager should use
to orient you to your new position. Don't forget to
think about things like how you're going to need to
learn about the vision, mission and direction of
the organization; its philosophy of service; the
goals of the department, team, unit; expectations
for you; methods of skills assessment and programs
for competency; unit policies; and anything else
you think should be included. Post your plan in the forum
for Assignment
3C
(Managed Care).. Read each other's plans and
discuss in Assignment
3C
(Managed Care) by
raising questions, asking for clarification, making
suggestions, offering alternatives, etc. Skills for
Clinicians in Today's Managed Care
Marketplace Modified from: Vail,
Carolyn (January, 1996) Professional
Development in Managed Care, ERA
Symposium, Washington, DC.
ASPEN Assignment
3D: Midsemester Self Evaluation of
Progress in the Course Click
here
to go to self-evaluation. Home | WebCT | Unit 1 | Unit 2 | Unit 3 | Unit 4 | Project | Evaluation | Site Map |