Respond to at least two of your colleagues* on two different days, offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions.

At least 2 peer reviewed citations.

Ms SA.

The growing use of electronic health records (EHRs) to document care now offers the opportunity to use the data captured in practice for discovering knowledge to transform health care. The documentation entered by nurses into EHRs is a potential source for discovering the impact of nursing care on patient outcomes and using the knowledge to improve care (NCBI, 2017).  Nursing informatics is important to nursing and health care because it focuses on representing data, information, and knowledge. Nursing informatics in an ever-evolving specialty (McGonigle & Garver Mastrian, 2018). Informatics is used in direct patient care by supplying physicians, nurses, physical therapists, aides, and other caregivers with information that can be used in collaborating patient care.

I currently work at a correctional facility where information is shared through our electronic health records. Our information specialists are responsible for supplying data based on patient information from electronic health records. Our information specialists have recently compiled data that reflects our compliance with patient appointments. The data captured has allowed medical staff to evaluate the areas in which patient appointments have been delayed. With this data, we have been able to communicate with facility Wardens to address the concerns for patients transported to clinic areas.

Improvements can be made by educating our staff on the advantages of utilizing informatics to enhances our medical services. Competency in nursing informatics strengthens our clinical decision-making skills. The informatics competency helps nurses use information and technology to communicate, manage knowledge, mitigate error, and support decision-making at the point of care (Practice Matters, 2017). The nursing profession is rapidly changing to keep up with advancements and new challenges in the healthcare field. Informatics is being used to address the challenges of the day, significantly impacting the way nurses function in inpatient care settings. One of the primary ways that informatics has changed nursing practice is through documentation. Informatics improves the coordination of this information, allowing nurses to give their patients all the information they need, improving both outcomes and satisfaction with care.

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Respond to your colleagues by explaining how the  leadership skills they described may impact your organization or your  personal leadership, or by identifying challenges you see in applying  the skills described.

At least 2 references in each peer responses!

Incivility and bullying have long been a problem within nursing and the healthcare profession.  Edmonson defines incivility as “the destructive and harming behaviors of disrespect and degradation” (Edmonson, 2017 p. 40).  In nursing it is known as “getting a thick skin” and “eating their young” (Edmonson 2017).  Incivility is harmful to the individual, patients, the organization, and has long-term negative effects.  It not only harms the individual but it can affect patient care and decrease morale in the work place.  Incivility can contribute to medical errors, preventable adverse outcomes, poor patient satisfaction, and increase cost of care.  It can create unhealthy and hostile work environments and can undermine the nurse’s idealism and professionalism.  Yet, disruptive behaviors such as incivility and bullying are tolerated in many settings and can cause clinicians, managers and staff to seek positions elsewhere.   Some key behaviors of incivility include rude comments, offensive or condescending language, public criticism, screaming, and disregard for interdisciplinary input on patient care (Lachman 2017).  Disruptive behaviors can have long lasting negative effects and affect the health and well-being of individuals due to psychological and physical stressors.  They can develop stress related disorders resulting in feelings of failure, tension and depression (Kim 2018).

Healthful environments are grounded in a culture that values diversity supports communication, trust and collaboration.  To create a culture of civility that promotes a safe environment it is the responsibility of nurse leaders to support staff.  One strategy to creating a culture that does not tolerate incivility would be to socialize new and current employees.  Rather than let the day-to-day interactions of employees establish expectations, the nurse leader should clearly define behaviors that are acceptable and unacceptable to everyone.  Establish expectations of how staff should treat each other and post those guidelines (Smith 2018).  A second strategy to creating a healthful environment is to have a team approach to establishing team norms of civility.  Team members determine how norms are put into use and how to abide by them.  This approach will establish accountability among all team members of the organization (Clark 2016).  Having an honest and open approach to communication where people should not be afraid of telling their stories will help to empower people so speak out.  Creating a culture of structural empowerment allows people to regain their power, speak out against disruptive behaviors, and lower the levels of incivility (Lachman 2015).  An empowered culture will help maintain strategies that are in place, reduce tolerance of incivility and hold people more accountable.

When I was a nursing student I witnessed behaviors where the preceptor was deliberately being hard on the student, fortunately I had a preceptor who was nice and enjoyed teaching me.  As I entered the work force my first job was in the ED.  The manager of the ED was a nurse and she had an open policy where if anybody had issues they can come to her and discuss their grievances.  I noticed that the morale of the department was always good and everyone got along well.  The manager used a communication strategy called CUS (concerned, uncomfortable, safety) where people can come to her to address concern, state uncomfortable situations, and focus on safety.  When people have disagreements, the manger would talk to both of them in the office at the same time and let each person talk about their grievances.  It seemed to work pretty well as issues were promptly resolved and everybody seemed happy with the results.

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