Unit HLTENN043 Implement and monitor care for a person with
Logan is a graduate registered nurse completing a full-time graduate program in a large regional hospital in Australia. Last week, Logan started a rotation in the respiratory ward, after three months in the forensic mental health unit. The respiratory ward uses a team nursing model of care, where a registered nurse and an enrolled nurse work together to care for eight acutely unwell patients. The ward is supported by assistants-in-nursing who provide assistance with activities of daily living for patients. A senior registered nurse acts as team leader each shift and provides oversight and guidance for challenging and unexpected situations. Logan writes in a journal daily. Their most recent journal entry is below: This week has been so difficult. I feel so overwhelmed. The ward is so busy and the patients are so complex. I felt so confident working in forensic mental health because I knew the routine, but here I just can’t seem to get all my work done. Twice now I’ve had to stay back late in order to finish writing my notes because I ran out of time during my shift. I never seem to have time to take a proper break. I can’t relax after a shift because I just keep going over all the things I could have done better in my head. Today I was working with Shelby, an enrolled nurse who has been working on the ward for 10 years. Shelby and I had taken four patients each and were working our way through the 8am medication round. As I walked into a patient’s room I saw Pravin, a new assistant-in-nursing, about to increase the oxygen delivery rate at the wall (the patient had nasal prongs on). I asked Pravin to stop and explain his actions. Pravin said that he noticed the patient was breathing fast and had told Shelby. Shelby had told him to increase the oxygen rate, and he knew how to do it because his mum was on oxygen at home. I completed a respiratory assessment and titrated the oxygen according to the doctor’s order in the patient’s chart. Then I went to find Shelby. Unfortunately Shelby was very dismissive. “You were so far behind on your med round, I thought I was helping. It’s just oxygen. ” I told Shelby that AINsare not allowed to adjust oxygen levels (it is against ward policy). Shelby just scoffed, rolled her eyes at me, and walked away. I went and told the team leader Anashe, who said “That’s just Shelby. She’s always been a bit rogue and she can be a bit difficult to talk to.” I asked Anashe if I should complete an incident report and she seemed surprised. “Why? You stopped Pravin, so what’s the issue?” I was confused, but I didn’t want a fight so I just left it. Everything just seems so different to what I know. No one seems to care about best practice. I love working with the patients but trying to get along with the team is so hard. Maybe I’m just not meant to be a nurse … Describe two leadership skills Logan could use to help resolve the conflict with Shelby.
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