Current Trends & Issues in Nursing Profession PDF

[NUR81025] Professional Adjustment - PHILIPPINE QUALIFICATIONS FRAMEWORK Current Trends & Issues and Future The Philippine Qualifications Framework describes the...

[NUR81025] Professional Adjustment - PHILIPPINE QUALIFICATIONS FRAMEWORK Current Trends & Issues and Future The Philippine Qualifications Framework describes the levels of educational qualifications and sets the Directions in Nursing Profession standards for qualification outcomes. 4NUR-4 | Asst. Prof. Ma. Carina D. Rebueno, PhD, RN It is a quality assured national system for the BY: MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL development, recognition and award of qualifications based on standards of knowledge, skills and values GLOBAL TRENDS IN NURSING acquired in different ways and methods by learners and Nurse shortage will continue. workers of the country. Nursing jobs numbers will continue to increase increase use of online nursing programs nurses will need higher education that is focused on BSN degrees Rise of telemedicine Traveling nurses ○ high salary but no security of tenure or benefits Increased specialization and career path options Self-care for nurses Nursing informatics will grow Increased salaries and benefits Bilingual nurses will be more in demand. Increased use of virtual simulation Holistic care will become more popular. Nurses are retiring later. Working more with technology Males entering the workforce will rise GLOBAL ISSUES IN NURSING Telehealth and technology in healthcare Essential need for self-care in nursing Nursing advocacy and action Evolution of the workplace Expanding distance education Entrepreneurship and intrapreneurship opportunities R.A. 10968: THE PQF LAW Nurse navigators An act institutionalizing the Philippine Qualifications Specialization Framework (PQF), establishing the PQF - National ○ Advanced practice in nursing is still not yet approved Coordinating Council and appropriating finds therefore NURSING CHALLENGES IN THE TIME OF RAPIDLY CHANGING MUTUAL RECOGNITION AGREEMENT GLOBAL AND LOCAL HEALTHCARE LANDSCAPE Mutual Recognition Arrangements (MRAs) are framework Given global demographics, state of the world's health, arrangements established in support of liberalizing and global healthcare trends and advances in technology, how facilitating trade in services. should the Philippine Nursing agenda be shaped? ○ nurse What nursing competencies should be developed and ○ dentist further enhanced to be more responsive to the rapidly ○ engineer changing global and healthcare landscape? ○ tour guide What interventions need to be in place to ensure that the ○ surveyor Philippine health workforce in this time of rapidly changing ○ accountant healthcare landscape is responsive to both local and ○ doctor global needs? ○ architect MRAs aim to facilitate mobility of professionals / skilled ASEAN ECONOMIC COMMUNITY labor in ASEAN. Community is the realization of the region's end goal of economic integration. R.A. 11223: UNIVERSAL HEALTH CARE (UHC) LAW It envisions ASEAN as a single market and production to provide better healthcare delivery to the Filipinos base, a highly competitive region, with equitable economic An act instituting universal health care for all Filipinos, development, and fully integrated into the global economy. prescribing reforms in the health care system, and appropriating funds therefor ASEAN QUALIFICATIONS REFERENCE FRAMEWORK Progressively realize UHC in the country through a The ASEAN Qualifications systematic approach and clear delineation of roles of key Reference Framework (AQRF) is a common reference agencies and stakeholders towards better performance in framework that enables comparisons of education the health system qualifications across participating ASEAN Member States Ensure that all Filipinos are guaranteed equitable access (AMS). to quality and affordable healthcare goods and services, and protected against financial risk OBJECTIVES OF AQRF Support recognition of qualifications PHILIPPINE SKILLS FRAMEWORK: UPSKILLING AND RESKILLING Encourage the development of qualifications frameworks OF FILIPINO NURSING PROFESSIONALS that can facilitate lifelong learning Partnership with industry/hospitals for more exposure to Encourage the development of national approaches to clinical areas and community immersion. validating learning gained outside formal education Consistent updating and retooling of the BS program Promote and encourage education and learner mobility aligned to the needs of the country. Support worker mobility Offering of other job roles for underboard nursing Improve understanding of qualifications systems graduates that can help augment our healthcare system. Promote higher quality qualifications systems [NUR81025] Professional Adjustment - Finals Topics 1 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  Involvement of industry partners / hospitals in the training NATIONAL HUMAN RESOURCES FOR HEALTH MASTERPLAN FOR and upskilling of nursing graduates for clinical immersion 2020 TO 2040 and training. FIVE STRATEGIC ACTIONS TO BUILD THE FUTURE Providing incentives and financial support to deserving HEALTH WORKFORCE: HRH prepared to meet the health nursing graduates who will pass the nursing licensure needs of the population examination ○ Align HRH policies with PHC-oriented health systems ○ Strengthen HRH stewardship in health systems R.A. 10912 - CONTINUING PROFESSIONAL ○ Producing and maintaining quality HRH DEVELOPMENT (CPD) LAW ○ Steering the private sector for public good An act mandating and strengthening the Continuing ○ Managing distribution and productivity in the public Professional Development program for all regulated sector professions, creating the Continuing Professional Development Council, and appropriating funds therefor, NEW PROVISIONS IN THE PROPOSED BILLS and for other related purposes Strengtheninign the regulation of the profession through Requires CPD as the mandatory requirement for the the empowerment of PRBON renewal of Professional Identification Card of all Ensuring top-level leadership in nursing regulation, registered and licensed professionals under the regulation education, service and research of the PRC. Promoting competent and credentialed professionals through CPDD and career progression CAREER PROGRESSION AND SPECIALIZATION PROGRAM AND Ensuring safe staffing and nursing sill mix for qualithy care CREDIT ACCUMULATION AND TRANSFER SYSTEM PROGRAM through the institutionalization of the Nursing Human (PURSUANT TO RA 10912 - CPD LAW AND RA 10968 - PQF LAW) Resource for Health Management System (NHRHMS) in CPSPN refers to the program of differentiating nurse level all settings and sectors standards, the system of credentialing specialty Preparing credentialing and recognizing nurses for organizations and interest groups, and certification of advanced practive in nursing to meet the gap created by individual… increasingly complex healthcare needs, the strong focus of UHC on primary care and the need to reach Filipinos in ADVANCE PRACTICE NURSING inaccessible or underserved settings Advanced Practice Nursing refers to the specialized and expanded role of an APN It involves certification of nurses with higher degree of qualifications by the Board, thereby providing the former with providing the former with opportunities for expanded professional scope of practice It maximizes the use of graduate education in nursing and the nurse’s expertise to ensure safe, holistic and quality care to individuals, families, population groups or communities towards achieving quality, accessible, and affordable health care for all filipinos CERTIFICATION VS. CREDENTIALING Certification refers to the process of validating achievements through a variety of measures and assessment strategies to confirm or attest to the competency of an APN upon completion of a specialty program or Continuing Professional Development (CPD) program, or both, The certification is issued by the program… ○ meeting the requirement Credentialing refers to the formal recognition of a specialty organization or interest group conferred by the PRC and the Board upon the recommendation if the CPSPN after complying with the PSG ○ giving the credentials to operate PHILIPPINE PROFESSIONAL NURSING ROADMAP 2030 Curriculum of CON is similar to the Roadmap [NUR81025] Professional Adjustment - Finals Topics 2 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  ○ Employees and consumers are stakeholders; teachers and students are involved in curriculum Promotion of Decent Work Environment planning for Nurses Encourages open communication and teamwork ○ Employees should not be afraid to give feedback and POSITIVE PRACTICE ENVIRONMENT opinions Factors to promote the productivity and outcomes of the ○ Professional feedback (as much as possible workers shouldn't be personally address) Settings that support excellence and decent works ○ Be assertive Ensures the health, safety and personal wellbeing of staff Fosters a culture of mutual trust, fairness, and respect ○ Health: consider the environment, interpersonal ○ Supervisor is the one influencing the culture in the relationships, types of patients, PPE being provided workplace ○ well-being: sick leaves, zumba, ○ If supervisor from nepotism = chaotic workplace Supports quality patient care ○ Supervisor should always trust their employee, listen improves the motivation, productivity, and performance of first to the employees before you judge individuals and organizations Adopts policies to positively encourage reporting of ○ Retention and performance is multifactorial professional misconduct ○ Competency-knowledge skills and attitude Provides clear and comprehensive job descriptions ○ Professionally: prepared through CPD ○ As leaders: Reemphasize the scope of the job Motivation: increasing the salary, remuneration: Ensures effective grievance procedures Positive work environments Positive nurse outcome… ACTIONS Positive patient outcomes PROFESSIONAL RECOGNITION 1. Recognizes health care professional competencies INSERT PIC OF VENN DIAGRAM HERE (relationship of practice 2. Promotes professional autonomy and control environment with job satisfaction and quality nursing care) 3. Rewards contribution and performance 4. Measures employee satisfaction and acts on outcomes ○ How satisfied are you with what you are doing MANAGEMENT PRACTICES 1. Commits to equal opportunity and fair treatment 2. Provides adequate and timely compensation 3. Maintains effective performance management systems 4. Offers decent and flexible benefit packages 5. Involves employees in planning and decision-making 6. Encourages open communication and teamwork a. Vital to encourage nurses to open up and report errors b. E.g. incident report culture -> punitive which causes secondary trauma Good practice environment=job satisfaction=good quality 7. Fosters a culture of mutual trust, fairness, and respect of nursing care 8. Adopts policies to positively encourage reporting of professional misconduct ?? 9. Provides clear and comprehensive job descriptions Professional recognition 10. Ensures effective grievance procedure Management practices Support structures SUPPORT STRUCTURES Education 1. Invests sufficiently in health and work environments Occupational health and safety 2. Fosters strong employment relationships 3. Applies regulatory frameworks for safe workplaces PROFESSIONAL RECOGNITION 4. Provides adequate equipment, supplies, and support staff Recognizes health care professional competencies a. Lack of equipments ○ Specialization: if nurse is trained with dialysis put b. Nurses in an infectious ward without PPE them in dialysis c. Nurses handled Radioactive patients without Led ○ Nurse is trained in ecg reading = specialization gown should be in telemetry 5. Engages employees in continuous assessment promotes professional autonomy and control a. feedbacks ○ allows decision making (not a micromanager, where 6. Promote healthy work-life balance all your actions is being supervised) a. Always OT and on-call: Prevent burnout ○ Provide opportunity to a professional to grow 7. Offers employment security and work predictability ○ ask for participation 8. Ensures practice under an overarching code of ethics Rewards contribution and performance 9. Communicates and upholds standards of practice ○ Even if it is monetary or non-monetary (recognition) 10. Reviews scope of practice and competencies Measures employee satisfaction and acts on outcomes ○ Feedback to recognize there is always room for EDUCATION growth with constructive criticism 1. Supports opportunities for professional development a. Dont give options to nurses to choose CPD or MANAGEMENT PRACTICES Working (if umaattend sa cpd, bawas sa sweldo) Commits to equal opportunity and fair treatment 2. Offers thorough orientation programs ○ Avoiding favoritism and nepotism 3. Fosters effective supervision, mentoring, and coaching → ○ Nepotism: favoring family, friends, close associates supportive relationship over others a. Preceptorship and modeling encourage one to stay Provides adequate and timely compensation b. Senior and junior teacher during a skills lab ○ Responsibility of management demonstration Maintains effective performance management systems Offers decent and flexible benefit packages/compensation OCCUPATIONAL HEALTH SAFETY ○ Benefits: free tuition, education opportunities 1. Adheres to safe staffing level Involves employees in planning and decision-making [NUR81025] Professional Adjustment - Finals Topics 3 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  a. More mistakes less confidence ○ Acuity of care - as TL, one should accomplish a TL 2. Adopts occupational safety and wellness policies worksheet to determine the acuity of care of each a. Check for puncture resistance containers and the patients to equal distribute the patient workload to availability of resources the members of the RLE b. Occupation jealth and safety law -employers should ○ Ideally, one should not give the new nurses the toxic adhere to it patients Preventable injuries WORKPLACE ISSUES ○ e.g. needle stick injury (no recapping) JOB SATISFACTION Workplace Violence it is very crucial ○ Could be lateral or horizontal; nurse-to-nurse Remuneration violence; nurse-to-staff violence ○ Adequate Salary ○ Know the watcher in patients who tend to be violent ○ Moonlighting - general practice, whether in the and orient the staff regarding the demographics and outpatient setting or in the hospital setting. You get protocols of the area paid by the hour. You fill the role of residents in hospitals without residency programs, but you don’t SAFETY CLIMATE FOR NURSES AND PATIENTS actually get to train Physical and Psychological Safety ○ nababayaran ng tama Climate of Learning ○ Salary is different from giving benefits. Salary is Climate of Leadership expected meanwhile benefits are given on top of ○ When the organizational climate enhances the salary to acknowledge hard work empowerment of individual employees, nurses Working conditions express greater job satisfaction and patients achieve ○ PPE better outcomes ○ how do you protect your employee ○ We can be a leader in our own way ○ communication, collaboration, and leadership contribute to adequate working conditions CRITICAL POINTS IN PROMOTING POSITIVE PRACTICE Training and qualifications ENVIRONMENTS ○ funds for employee training QUALITY PROFESSIONAL PRACTICE ENVIRONMENT STANDARDS. ○ Nursing training office: in hospitals, they are the one CANADIAN NURSES ASSOCIATION, 2013 (ADAPTED) responsible in training nurses 1. Leadership ○ Faculty development 2. Workload Management 3. Professional Development PRODUCTIVITY 4. Control Over Practice and Work-Life Motivation 5. Communication and Collaboration ○ Usually a number one factor 6. Culture of Safety ○ Find the right motivation and the right support system LEADERSHIP ○ Are you satisfied with the job? Is the key element in establishing Quality Practice ○ Which can be influenced by rewards, bonuses, and Environments and healthy workplace certificates Effective leadership is important in all nursing roles and Training affects workplace environment and the quality of care ○ Readiness- in order to be productive you should be provided ready, readiness is also obtained through several ○ There is role modeling in good leadership training. ○ Good leadership → good culture, values ○ Are you able to take advantage of the trainings given Leadership at all levels can be done through the ff: to you? ○ Involve staff nurses in decision-making Preparedness for the job ○ Nurses should be supported, mentored, and coached Provision of necessary equipment and technology to achieve full leadership potential ○ Senior leaders should be visible and accessible STAFFING CONSIDERATIONS ○ Nurses are encouraged to participate and provide Workload innovative and creative inputs to ensure safe care ○ Nurse-patient ratio (E.g in heart center 1:20, but have adequate facilities and equipment (soluset is single Climate of Leadership used only) When the organizational climate enhances the empowerment of ○ Private duty nurse is 1:8 ratio but it is understaffed individual employees, nurses express greater job satisfaction and Work environment patients achieve better outcomes. Cost efficiency and effectiveness Acknowledge of efforts should not be deprived from a ○ Cost-cutting - instead hiring new nurses, the person it promotes job satisfaction management rather make hired nurses do overtime ○ they hire undergrads instead of phd, since in house WORKLOAD MANAGEMENT training would be cheaper Ensure a nursing care delivery model (have a framework) Patient Complexity that ○ The more complex the care, the more time needed to ○ Supports continuity of care be given to the patient ○ Enables nurses to develop a therapeutic relationship ○ not all nurses have specialization with their clients Skill level and mix of nursing staff ○ Allows nurses to practice to the full scope of their ○ Do not give complex cases to new nursing staff education and experience ○ There should be adequate junior and senior nurses Volunteer in areas that you are good at ratio in a ward (hindi pwede puro bago sa isang ward) Safe staffing level at all times. ○ Ensuring an appropriate number of staff with a SAFETY CONSIDERATIONS suitable mix of skill levels Excessive Workload Available at all times ○ Burnout - double shift will lead to medication error Meet patient care needs ○ Excessive workload - only 2 nurses in the ward (4 Hazard-free working conditions are maintained blood transfusion and only 2 nurses) ○ In USTH they did functional nursing in their ward ○ Patient assignment is crucial advantages: efficient Workload Measurement However it does not establish rapport [NUR81025] Professional Adjustment - Finals Topics 4 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  ○ Later, they used primary care nursing model since it ○ how do you promote wellness promoted the nurse-patient relationship more (better Responsibility and Accountability rapport) ○ Participate in policy identification and development Work-life Balance Safe Staffing levels and Mix ○ Personal, team, and organizational needs Safe staffing is ensuring an appropriate number of staff with. There should always be a gap between personal and suitable mix of skill levels: professional life. available at all time ○ e.g. a nurse having a relationship with the patient’s meet patient care needs relative hazard-free working conditions are maintained How to promote safe staffing: PROFESSIONAL RECOGNITION Consider nurse patient ratio Recognize the full range of competencies and provide the Consider level of skill autonomy for these competencies to be fully utilized. Level of care Promote professional autonomy and control over practice and pace of work. Recognize and reward employee MATRIX FOR STAFFING AND DECISION MAKING (TAMSE, 2018) contribution/performance. ○ Always give recognition to employees (kahit daw ITEMS ELEMENTS/ DEFINITION nagbuhat lanh ng folder) Regularly assess employee satisfaction and act on Patients Patient characteristics and number of patients outcomes. Individual patient intensity; across the unit intensity; COMMUNICATION AND COLLABORATION Acuity of Care variability of care; admissions, discharges and transfers; volume, workflow Open communication ○ ward meetings (monthly) wherein issues are Context and Geographic dispersion of patients, size and layout of discussed Organizational patient rooms, technology (cell phone, computers), ○ supervisor talks to staff who is always absent, late Policies policies Appreciation of individual role Collaborative relationship Competency Professional expectations; preparation and experience, ○ Health Team access to continuing education ○ Clients and family ○ Important that nurses and doctor don't have a barrier in order to have collaboration Develop Staffing Guidelines Professionalism Culturally sensitive and equity-based Mutual Support Clear and updated competency profile Acuity driven CULTURE OF SAFETY ○ Response to the level of care the patient needs ○ Depend on the type of patients Establish mechanisms to ensure physical and ○ Acuity is always monitored by the supervisor (ideally psychological safety a nurse) since they are the one that decides the ○ physical: fire drill, earthquake drill lahat ng drill, staffing of the ward and what ward the pt will go shooting drill, driller (infectious pt, clean pt) ○ psychological: Crisis something something Nurse sensitive outcomes Adhere to occupational safety and health policies ○ What the nurse needs ○ occupational and health safety law Value generational diversity The provision of quality nursing care is supported by the Contingency plans physical environment, equipment, supplies, and support, services/personnel PROFESSIONAL DEVELOPMENT Comprehensive health, wellness, and safety/injury prevention programs are available and accessible Learning is a lifelong process, especially when working in ○ Physical examination is required a rapidly changing healthcare environment There are measures to help prevent and address ○ Code of ethics: nurses have an ethical responsibility discrimination, aggression, abuse, violence, and workplace on professional development bullying Commitment to continuing competence at all levels of the ○ Psychological safety, debriefing process organization helps strengthen positive practice Nurses have opportunities to participate in debriefing environments activities following critical incidents (College of Registered Nurses of Nova Scotia, 2014) PSYCHOLOGICAL SAFETY SUPPORT FOR PROFESSIONAL DEVELOPMENT Strengthening individual’s emotional resilience through Orientation or transition programs at all levels interventions to promote self-esteem, and life and coping ○ To help get accustomed with the skills, knowledge skills (e.g., communication, negotiating, relationship) and protocols of the hospital ○ Best measure to battle mental health issue is a good Availability of relevant training and continued educational support system opportunities ○ Avoid creating division within the team ○ In the hospital there is an nursing training office Strengthening the workplace ○ In the con: faculty development committee Reducing structural barriers to mental health Support for evidence-based practice and nursing research Support mentoring and preceptorship relationship ○ Mentoring will give you emotional support STRATEGIES IN PROMOTING POSITIVE PRACTICE ○ Preceptor will give you a formal relationship with ENVIRONMENTS grades as output (matter of fact) Continuing to promote the nursing role Encourage innovations and creativity Defining the scope of nursing practice so nurses, other Provision of relevant performance evaluation: peer disciplines, and the public are aware of the profession’s evaluation evolution Lobbying for professional recognition and remuneration CONTROL OVER PRACTICE AND WORK-LIFE Developing and disseminating a position statement on the importance of a safe work environment Autonomy ○ Collaborative decision making [NUR81025] Professional Adjustment - Finals Topics 5 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  Ensuring that other disciplines are involved in the development of policies for a safe work environment Supporting research, collecting data for best practice, and disseminating the data once it is available Encouraging educational institutes to enhance teamwork by providing opportunities for collaboration and emphasizing teamwork theory Presenting awards to healthcare facilities that demonstrate the effectiveness of PPE through recruitment and retention initiatives, reduced dropout rates, public opinion, improved care, and higher patient satisfaction rate Using the tool kit to provide background information about the importance of PPE POTENTIAL OUTCOMES OF POSITIVE PRACTICE ENVIRONMENTS TO THE NURSE Improvement in morale and job satisfaction Supportive work environment can enhance nurses’ capacity for participatory leadership and collaborative decision making TO CLIENT CARE Enhance ability to provide safe and quality client care Create a more professional work environment that impacts on nurse sensitive client outcomes (E.g. decreasing adverse events, increasing client functional status, and improving symptom management) TO HEALTH SYSTEM EFFICIENCY Decreased absenteeism and workplace injuries Improved internal processes and maximized productivity while balancing workload Success of recruitment and retention initiatives Decreased costs for the health system Enhanced collaboration and communication will result in improved team effectiveness in the utilization and delivery of quality services TO HEALTH SYSTEM EFFECTIVENESS Enhanced collaboration and communication will result in improved team effectiveness in the utilization and delivery of quality services. [NUR81025] Professional Adjustment - Finals Topics 6 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  If ever nawala sa trajectory from momentum or NURSING CAREER DEVELOPMENT AND ○ promise they can still re-enter PLANNING LEVELS OF NURSING EXPERIENCE (BENNER, 1982) CAREER DEVELOPMENT The intentional career planning that must be viewed as a NOVICE critical and deliberate life process involving both the Beginner with no experience individuals and the employer Taught general rules to help perform tasks Provides individuals with choices about career outcomes ○ through orientation when entering the workplace to rather than leaving it to chance know the environment Planning vs development Rules are context-free, independent of specific cases, and ○ Planning is on your own applied universally ○ While career development involves the employer Rules cannot express which tasks are most relevant in real Involves employer so they can be mentored life or when exceptions are needed ○ What’s your plan? It includes what is your plan if you ○ in Decision making in patient care or any other issues plan do be a chief nurse, dean, etc. in the institution you express kung ano sa tingin mo kelangan and relevant at the moment STAGES OF CAREER DEVELOPMENT ○ Not able to see the whole since you don’t know every (SHIREY, 2009) rule yet PROMISE ADVANCED BEGINNER First 10 years of nursing employment Demonstrate acceptable performance Nurses in thesis stage are less experienced and tend to Has gained prior experience in actual situations to experienced and tend to experience reality recognize recurring meaningful components Making career choices is critical in this phase Principles, based on experiences, begon to be formulated Milestones to be attained include to guide actions ○ socialization to the nursing role (becoming an After probation period usually after 6 months insider); ○ After 6 months you go through competence ○ building knowledge, skills, abilities, credentials, and evaluation then you get hired for regularization an education base; Learning from experience Nakuha experience, trainings ○ gaining exposure to a variety of experiences; COMPETENT ○ Identifying strengths and building confidence; and Typically 2-3 years’ work experience in the same area or in ○ Positioning for the future similar day-to-day situations More aware of long-term goals MOMENTUM gains perspective from planning own actions based on reflects the nurse with 11-29 years of experience conscious, abstract, and analytical thinking and helps to Nurses in this phase are experienced clinicians with expert achieve greater efficiency and organization knowledge, skills, abilities, credentials, and education base There is already familiarity in the ward and they are already ○ Saka ka palang may master’s phd etc. actualizing their career plans ○ engaging in PNA Starting to have Organizational skills: ○ knowing your purpose as a nurse ○ Not only thinking about self, thinking about the ward It is a time of accomplishment, challenge, and a sense of purpose PROFICIENT ○ Reflection of your role as a nurse Perceives and understands situations as whole parts The individual often achieves enough expertise to be a role More holistic understanding improves decision making model to others. Learns from experiences what to expect in certain Milestone Include: situations and how to modify plans ○ Further building confidence one’s competence important to have senior nurses since they learned from ○ Developing experience, gaining mastery, and experience and look at thing holistically establishing a professional track record; and ○ In patient: novices notice phlebitis and would perform ○ Finding a voice through aligning strengths with a warm compress but for a proficient nurse they passion would anticipate maybe they need to change line, elevate etc. HARVEST there is anticipation Nurses with 30-40 years prime experience Nurses with more than 40 years - building a legacy EXPERT ○ E.g maam villarama No longer relies on principles, rules, or guidelines to The experiential value of nurses may begin to decline connect situations and determine actions when others perceive them as obsolescent. ○ Nurses na nagdistress pt alam niya na agad gagawin ○ They feel like their time has come and they already feel kasi under doctor purino alam niya na yun binibigay ni irrelevant. doc They must actively strive for on-going reinvention to renew ○ unconscious competence - sir LP their potential value to their coworkers. Much more background of experience Milestones to be conquered include: Has intuitive grasp of clinical situations ○ elevating their mastery to sage practice for advancing ○ Foresight: hindi pa nangyayari pero anticipate niya na the profession; ○ THINK FORWARD THINK BACKWARD ○ positioning as a professional statesperson; and Performance is now fluid, flexible, and highly proficient ○ establishing a legacy JUSTIFICATIONS FOR CAREER DEVELOPMENT REENTRY Reduced employee attrition Many nurses who were no longer working in the Equal employment opportunity profession but who possess the necessary training and Increased opportunities for employee growth experience to do so may reenter the work setting, ○ Career development is for lifelong learning especially with nursing shortage ○ If employees do not grow patient outcomes are compromised [NUR81025] Professional Adjustment - Finals Topics 7 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  Improved quality of work life Improved Competitiveness of the organization ○ E.g.Pacucoa accreditation: 100% phd Obsolescence can be avoided, and new skills acquired Evidence-based practice promoted INDIVIDUAL RESPONSIBILITY FOR CAREER DEVELOPMENT Self-assess interests, skills strengths, weaknesses and values ○ Ano ang gusto ko? ○ Ano kaya ko gawin?(knowledge,skills, resources) Determine goals Assess the organization for opportunities ○ Do not just enter organization determine their benefits, mission, vision Assess opportunities outside the organization Develop strategies Implement plans Evaluate plans Reassess and make new plans as necessary, at least biannually ORGANIZATION’S ROLE IN EMPLOYEE CAREER DEVELOPMENT Integrate individual employee needs and organizational needs Establish, design, communicate and implement career paths Disseminate career information Post and communicate all job openings within the organization Assess employee’s career needs Provide work experiences to further employee development ○ Experience tells you what you want Give support and encouragement Develop new personnel policies as necessary, at least biannually Provide training and education [NUR81025] Professional Adjustment - Finals Topics 8 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  Professional development experiences, presentations, APPLY FOR A JOB consuitations & publications Professional and community activities PREPARING A LETTER OF APPLICATION Honors and awards CONTENTS OF A LETTER OF APPLICATION Letter of thanks from patients, families, peers, Source and purpose organizations and others. ○ Hospital director ○ Chief nurse INTERVIEW Qualifications Face to face conference between two people about Reference something ○ To further… my background… these are the… A two-way conversation in which you will gain as well as ○ How did you know about the opening? give information ○ Attached below are the requirements for application For the employer, gives him/her chance to assess the such as… applicant's personality, alertness in answering questions, Request for personal interview poise, command of the spoken language and the like ○ I can be contacted through this email/number For the applicant, gives him/her a background of the institution, its potential as a working place, its philosophy USEFUL POINTERS IN MAKING A LETTER OF APPLICATION & objectives, etc. Use clean, white, unlined paper. Ask questions about the job. Use ink or ball pen in writing. You may want to type the Thank the interviewer for giving you some of his or her letter if you prefer. time. Use proper salutation. Give yourself time to think about the position. Observe proper margin and paragraphing. If the prospective employer does not answer, you may Write in a courteous manner. write a follow-up letter stating your interest in the position. Enclose return postage. Way of employer to get to know you, way of physical ○ Email na to ngayon assessment if your able to represent the institution. CREATING A RESUME PREPARING FOR AN INTERVIEW Brief overview of your qualifications for a position Make an appointment by mail or telephone ○ Brief and highlight work experience, education Be at the place at the appointed time background (with honors, any awards), examinations Know something about the institution where you will apply taken, trainings ( IV therapy, BLS, ECG) so that you can answer questions intelligently ○ Supposedly 1st page you catch the attention of the Be at your best employer ○ Dress properly and professional ○ Usually do not include hobbies Knock before you enter Provide the employer with a way to identify quickly when Bring credentials such as your registration card, residence her you have the basic qualifications for a position certificate, tax account number and the like. To present you in the most positive light to be consider the Choose an institution that aligns with you core values position in which you are interested make it short and straightforward. remove unnecessary info DURING INTERVIEW CONTENTS OF A RESUMÉ Ask questions about the job Thank the interviewer for giving you the opportunity Objective give yourself time to think about the position Credentials If the prospective employer does not answer, you may Employment history write a follow-up letter stating your interest in the position Education additional experience Personal references NURSING PHILOSOPHY AND BELIEFS What is your philosophy of nursing? POINTS TO CONSIDER IN MAKING A RESUMÉ Is there a nursing theorist that you use as a basis for your nursing practice? Should be on standard-sized (8.5x11), white or off-white, What do you believe is the most central concept to good quality paper support excellence in nursing? Do not photocopy. Use wide margins, spacing, indentations, bullets, and numbering to separate different sections and topics. PERSONAL GOALS AND PLANNING Underline or bold print important items or highlight them Where do you see yourself in 1 year? 5 years? 10 years? with an asterisk or bullet to draw swift attention. Have you developed any professional goals? If so, would ○ Important: Work experience and licensure you sharethose with me? Why do you want to work here? DEVELOPING A PROFESSIONAL PORTFOLIO What plans do you have for continuing education in nursing? A collection of materials that document a nurse's What do you see as your weakest area in nursing? competencies and illustrate the expertise of the nurse What do you see as your strengths in nursing? Maintaining a professional portfolio avoids lost opportunities to save documents because professional nurses should always have documentation readily PROBLEM SOLVING available to pursue promotion, to consider anew position, Identify a problem in patient care that you encountered as or to apply for another position in the present employment. a student and explain how you solved the problem Picture and compilation of evidences of competencies Describe a difficult patient with whom you worked. Include why you found that patient difficult and how you managed CONTENTS OF A PROFESSIONAL PORTFOLIO the situation Identify a situation in which you were involved in a conflict Biographical informations and describe how you handled that situation. If you had it Educational background to do over again, what would you do differently? Certifications achieved Employment history A resume A competence record or checklist TECHNICAL SKILL Personal and professional goals What technical nursing skills do you feel comfortable performing? [NUR81025] Professional Adjustment - Finals Topics 9 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  What skills will you require assistance with? ○ Reading professional journals What do you do when you encounter a technical skill you have not performed before? EMPLOYMENT CONTRACTS CONTRACTS THE EMPLOYMENT SETTING A meeting of minds between two persons whereby one binds himself, with respect to the other, to give something In what type of unit do you wish to work? or to render some service Why do you want to work here? A promise or set of promises which the law recognizes as Why do you think we should hire you for this position? a duty is not performed, the law provides a remedy two parties should agree NOTE: Be mindful of your contract. KINDS OF CONTRACT JOB RETENTION RETAINING A POSITION FORMAL Have adequate knowledge and preparation for the job- Agreement among parties involved and must be in writing. reading professional literature and attending clinical (Example: marriage contract, mortgages, work contracts) conferences. Usually may pirma ng attorney ○ Expansion and professional development are important to retain a job INFORMAL Have a well-developed personality. ○ “Pakikisama” Agreement which is concluded as the result of a written Develop good interpersonal relationship with your document or correspondence where the law does not co-workers by: require the same to be in writing ○ Being enthusiastic, dedicated to your work and being e.g. benta ng kotse nagpirmahan still informal because sincere, and considerate to others. Practice the not legally required golden rule. ○ Being tactful and dependable. Practice self-control. EXPRESSED ○ Develop the ability to adhere to social amenities and conditions and terms are given orally or in writing by the being socially compatible. parties concerned. ○ Having self-confidence and being cheerful. “Agreement” ○ Offering help when needed ○ Respect begets respect IMPLIED Develop proficiency in communication, both oral and concluded as a result of acts of conduct of the parties to written which the law ascribes an objective intention to enter into Be able to adjust to working conditions and to life patterns a contract characteristic of particular occupations and communities e.g. kunin kita PDN, sige po pwede po ○ Always adjust to your work setting Keep abreast with advances in medicine, nursing and VOIDABLE related sciences by reading professional literature and Those contracts wherein one of the parties is incapable of attending activities of professional organizations. giving consent to a contract. Those whose consent is vitiated by mistake, violence, HOW TO KEEP YOUR JOB intimidation, undue influence, or fraud. Work excellently. Inexistent from the very beginning Find ways of improving your job. e.g marriage contract- did not go through process, not legal Be a team player. age, una palang voided na kasi did not meet requirements Have a professional relationship with your boss. Be flexible. ILLEGAL Know, understand and live the values of your company. Steer away from office politics. Consent obtained by fraud Be loyal to your company. Those obtained under duress Be humble. Those obtained under undue influence Those obtained through material misrepresentation CAUSES OF FAILURE Expressly prohibited by law e.g. inemploy ka pero yung hospital hindi pala licences sa Incompetence or lack of the required ability and BIR etc, in short it was an illegal contract knowledge for the particular job. Poor interpersonal relationships, lack of compassion, dishonesty, boastfulness, and inability to get along with REQUISITES OF A CONTRACT people. 2 or more persons must participate ○ Introverted: PACU Parties involved must give consent ○ Magulo kausap: Psych Subject matter must specified: Personality defects such as imprudence in choosing ○ all things which are not outside the commerce of friends, insincerity, conceit, sarcasm, lack of tact, envy, man discourtesy, being too argumentative, apathy towards ○ object did not exist work or being too sensitive ○ all rights which are not intransmissible Inadequate knowledge in social conduct, too little time for ○ future inheritance in cases expressly authorized by relaxation and recreation law Indifference to need for professional growth, always ○ all services which are not contrary to law, morals, finding reasons for not attending professional meetings or good customs, public order, and public policy joining professional organizations. INEXISTENT CONTRACTS HOW TO TURN FAILURE INTO SUCCESS Object or purpose is contrary to law, moral, good customs Being competent etc. Taking it with pride Object did not exist from the time of transaction. Doing one’s best at all times Object is outside the commerce of man. Continue to develop professionally through: Contemplate an impossible service. ○ Observation Intention of the parties relative to the principal object ○ Staff development programs cannot be ascertained. [NUR81025] Professional Adjustment - Finals Topics 10 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  Expressly prohibited Reason for resigning Absolutely simulated or fictitious Express gratitude for kindness and consideration given E.g Nagagree per the contract itself was not inexistent during the period of employment. wala pina- notaryo, wala nag sign Attach clearance for money, work, and property responsibilities. VOIDABLE CONTRACTS those contracts wherein one of the parties ks incapable of DISMISSAL FROM A POSITION giving consent to a contract Negligence Those whose consent is vitiated by mistake, violence, Incompetence intimidation, undue… or fraud Malpractice E.g. mga naghohold ng passport Unprofessional behavior Breach of contract ILLEGAL CONTRACTS Resignation choice ng nurse dismissal is prerogative Consent obtained by fraud Those obtained under duress INVOLVEMENT IN PROFESSIONAL ORGANIZATION Those obtained under undue influence APO = PNA those obtained through material misrepresentation E.g ghost employer THE NURSING SPECIALTY GROUP may specialization BREACH OF CONTRACT Association of Dermatology and Aesthetic Nurses of the Prevention of performance Philippines, Inc. (ADANP) Failure to perform because or inconvenience or difficulty Association of Diabetes Nurse Educators of the Failure of cooperation in performance Philippines, Inc. (ADNEP) Abandonment of duty Critical Care Nurses Association of the Philippines, Inc. Substitution of performance (CCNAPI) Failure to used due care Enterostomal Therapy Nurses Association of the Philippines, Inc. (ETNAP) ADVANTAGES OF WRITTEN CONTRACT Filipino Mental Health and Psychiatric Nurses Society, Inc. Gerontology Nurses Association of the Philippines (GNAP) avoids uncertainty Military Nurses Association of the Philippines, Inc. Specifies a definite time within which it is binding so as to (MNAP) protect both sides against sudden changes without notice Mother and Child Nurses Association of the Philippines Sets standards and relieves an individual professional (MCNAP) person from haggling overcompensation National Association of Public Health Nurses, Inc. Open and well known so that use of written contracts Occupational Health Nurses Association of the tends to establish minimum standards Philippines, Inc. (OHNAP) It is definite on many details which may otherwise Peri-Operative Registered Nurses Association of the stimulate favoritism even among professionals, such as, Philippines, Inc. (ORNAP) hours of work, vacation allowances, holiday privileges, health and insurance provisions THE NURSING INTEREST GROUP Provides definite procedure in case of complaints about Association for Men in Nursing of the Philippines, Inc. substandard work, so that the employer has a clear (AMNP) course, and the nurse has protection Association of Deans of Philippine Colleges of Nursing, Creates a minimum certainty and security for the Inc. (ADPCN) employee ANG NARS, Inc. Association of Nursing Service Administrators of the DEFINITE COMMITMENTS STIPULATED IN A CONTRACT Philippines, Inc. (ANSAP) Hours of work Association of Private Duty Nurse Practitioners Salary Philippines, Inc. (APDNPP) Length of time of contract Catholic Nurses Guild of the Philippines (CNGP) Days of off duty Filipino Nurses United Details of duties and responsibilities including the course Global Society for Philippine Nurse Researchers, Inc. to be taken in case of non-fulfillment of the terms of (GSPNRI) contract Informatics Nurses Society of the Philippines, Inc. (iNurse SP) RESIGNATION National League of Philippine Government Nurses, Inc. Concludes your relationship with the employer on a cordial (NLPGNI) and positive basis. Nurses Christian Fellowship – Philippines, Inc. Reasons Philippine Nurses Environmental Organization (PNEO) ○ Seel better positions whether in the philippines or Philippine Nursing Informatics Association, Inc. (PNIA) abroad Philippine Professional Nursing Roadmap Coalition ○ Inability to adjust to the work situation, marriage, (PPNRC) children and or transfer Urologic Nurses Association of the Philippines, Inc. (URONAP) POINTERS IN MAKING A RESIGNATION LETTER Give advance notice ○ Should be 6 months notice ○ If not for 6 months you can be charged with AWOL (absence without official leave) Should be directed to the head of your department, often to the Director of Nursing. Copies should be sent to other supervisory people, such as the head nurse and the supervisor. LETTER OF RESIGNATION MUST CONTAIN THE FOLLOWING Date of resignation [NUR81025] Professional Adjustment - Finals Topics 11 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  relations. Such activities include the negotiation of formal PATIENT, SUBORDINATE AND labor agreements and day-to-day interactions between WORKPLACE AND PROFESSIONAL unions and management ○ as a nurse as an employee you have an option na ADVOCACIES magtayo ng union o hind ○ Requires lawyers ADVOCACY Labor Union - is an organization of workers, often in trade Protecting and defending what one believes in for both or profession, formed to protect their rights and interests self and others and improve their economic status and working conditions Nurses may act as advocates by helping others make through collective bargaining with employers. informed decisions, by acting as intermediaries in the environment or by directly intervening on behalf of others REASONS TO JOIN UNIONS Something that you believe in To increase the power of the individual To increase their input into organizational decision making PATIENT ADVOCACIES To eliminate discrimination and favoritism End-of-life decisions Because of a social need to be accepted ○ You cannot introduce your opinions Because they are required to do as part of employment Technological advances Because they believe it will improve patient outcomes and Healthcare reimbursement quality of care Access to healthcare ○ Equality to healthcare REASONS NURSES DO NOT JOIN UNIONS Transitions in healthcare A belief that unions promote the welfare state and oppose Provider-patient conflicts regarding expectations and the system of free enterprise desired outcomes A need to demonstrate individualism and promote social Withholding of information or blatant lying to pateint status Insurance authorizations, denials, and delays on coverage A belief that professional should not unionize Medical errors An identification with management’s viewpoint Patient information disclosure (privacy and confidentiality) Fear of employer reprisal Patient grievance and appeals processes Fear of lost income associated with a strike or walkout Cultural and ethnic diversity and sensitivity Respect for patient dignity EMPLOYMENT LEGISLATION Inadequate consents Labor Standards – establish minimum standards for Incompetent healthcare providers working conditions regardless of the presence or absence Complex social problems including AIDS, teenage of a union contract. pregnancy, violence and poverty Labor Relations – relate to the rights and duties of unions Aging population and employers in their relationship with each other. Equal employment – deals with employment SUBORDINATES AND WORKPLACE ADVOCACIES discrimination Invite collaborative decision-making Civil and Criminal Laws – statutory and judicial laws that Listen to staff needs proscribe certain kinds of conduct and establish penalties. Get to know staff personally Other Legislations – legal responsibilities of nurse Take time to understand the challenges faced by the staff managers that do not generally apply to industrial in delivering care managers Face challenges and solve problems together Support staff as needed Promote shared governance Empower to staff Promote nurse autonomy Provide staff with workable systems PROFESSIONAL ADVOCACY Professional issues are ethical issues. When nurses find a discrepancy between their perceived role and society’s expectations, they have the responsibility to advocate for the profession. If nursing is to advance as a profession, practitioners and managers must broaden their sociopolitical knowledge base to better understand the bureaucracies in which they live because legislator and policymakers are willing to deal with nurses as a group rather than as individuals, joining and actively supporting professional organizations allow nurses to have a greater voice in healthcare and professional issues Nurses must exert their collective influence and make their concerns known to policy makers before they can have a major impact on political and legislative outcomes. Nurses have great potential to educate the public and influence polivy through the media as a result of the public’s high trust in nurses and because the public wants to hear about healthcare issues from a nursing perspective. COLLECTIVE BARGAINING, UNIONISM, AND EMPLOYMENT LEGISLATION Collective Bargaining - includes activities between organized labor and management regarding employee [NUR81025] Professional Adjustment - Finals Topics 12 MEDINA, ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4