Changes Foreseen in the Role of Advanced Practice Nurse - Essay Example

Changes Foreseen in the Role of Advanced Practice Nurse: Relating Leadership to Health Care Reform BY YOU YOUR ACADEMIC ORGANIZATION HERE TUTOR HERE DATE HERE Changes Foreseen in the Role of Advanced Practice Nurse: Relating Leadership to Health Care Reform Introduction Advanced practice nursing has experienced many changes which have been driven by different internal and external improvements in health care. As the modern health care organization begins to recognize the importance of developing human capital to achieve quality and improvement, new leadership theories and philosophies become available for nurses or administrators to improve motivation and team focus. Changes to how health care organizations conduct operations are driven by cultural changes, technological changes, or simply sociological changes in how colleagues or managers within the organization view the importance of the interpersonal dimension. In order to be a quality-focused pediatric nurse practitioner capable of maximizing patient care and building staff unity, the nurse must take a leadership role within the organization in order to drive improvements. With health care reform currently on the forefront of society’s consciousness, it will be even more important to develop sound leadership skills in order to assist in this change process and also to improve relationships with patients of different socio-economic and cultural backgrounds. The future of health care, after potential reform, will change the methods by which nurses conduct their job role responsibilities. However, since this reform has not yet been built into solid legislation, it would be appropriate to compare this potential future for nurses with a preferred future to discuss how best to build a more effective organization. The future of nursing will require an individual with the ability to bridge gaps between colleagues, managers and patients in order to adjust to new health care reform-driven changes. The Change Process Health care reform is going to mean new demands for pediatric nurse practitioners, especially in terms of how management and nurses interact. Health care reform is going to change the process of controls within the organization, requiring more unity between different professional ranks of the business. In order to facilitate quality relationships of this type, the nurse “must be a diplomat, helping people get past their conflicts with one another and facilitate their working together” (Grossman and Valiga, 2009, p.138). Unfamiliar changes to health care delivery, imposed by the potential new reform policy, are going to create different reactions from colleagues and superiors. In some instances, these changes may be so radically-different from current operations that members of the organization try to resist these changes through lack of cooperation or other defense mechanisms. When frustrations are visibly noticeable with different nurses and physicians on the staff, all professionals within the organization must keep these transparent from the children in the pediatric care area. It is common knowledge that children have very complicated emotions when being treated in a health care environment and rely on sensations of security and competence from all members of the staff in order to deliver quality care. A diplomat will recognize when frustrations caused by health care reform are running high and facilitate quality conversations between different professionals. Inter-organizational conflict is a reality of any health care organization and they must “foster collaboration and keep lines of communication open between all group members” (Grossman and Valiga, 2009, p.138). Rather than allowing staff members within the organization to deal with their frustrations or concerns at the individual level, a competent nurse with solid leadership skills will ensure that any heated discussion, in front of youth patients, is minimized and will use diplomacy so that youths (or their visiting family members) do not receive a negative perception of the organization, its staff, or health care as a conglomerate whole. As a representative of the health care organization, a pediatric nurse practitioner must have solid negotiation and collaborative skills to give the best image possible to their employer. All professionals, at all levels of the health care organization, should be concerned with issues of reputation, as word-of-mouth is quite important in most health care divisions. In some urban areas, competition in this industry is quite high and one organization must differentiate itself from others through reputation or relationship marketing. There is likely going to be considerable resistance to health care reform (and other progressive changes) that could impact the organization’s profitability if lack of team unity is not present and people do not readily accept operational or process changes imposed by health care reform. Especially when children are the patient focus, it is important to avoid patients developing a sense of insecurity about their treatment process in the event of non-collaborative staff colleagues or high anxieties caused by health care reform-driven policy changes. One potential barrier to any type of change which might occur in the organization, not just health care related, involves tenure with different nurses on staff. This is also strongly tied to the political structure in terms of how nurses interact with one another in the working environment. “Many nurses have the attitude that they deserve more simply because they have seniority. When they don’t get more, they allow themselves to be victims of the system” (Grossman and Valiga, 2009, p.67). Using health care reform as the relevant example, long-term staff nurses have become accustomed to doing things a particular way and will likely be more resistant to any procedural changes which occur as a result of the reform. They may simply feel that they should not have to conform to these new ideals because they have more experience and then develop a moderate form of self-pity which can impact the quality of communications with other colleagues. Though this is a worst case type of scenario, a nurse should recognize that this is a legitimate phenomenon in nurses with seniority and then develop communications tactics which emphasize their accomplishments but also reinforce the importance of complying with the change process. Leadership and Team-Building “Leaders can maximize their successes as well as facilitate others’ achievements by fostering an environment more conducive to using emotional intelligence” (Grossman and Valiga, 2009, p.66). Emotional intelligence essentially means recognizing that others have needs and trying to be cooperative, using positive feedback and mutual colleague respect. An emotionally intelligent pediatric nurse practitioner will consider the viewpoints and perspectives of others, as well as performing in-depth, ongoing self-improvement analyses to become a better-rounded leader and caregiver. One positive example of showing emotional intelligence is through sponsoring of staff recognition days or publishing their individual accomplishments (Grossman and Valiga). In a leadership position, a nurse who recognizes concepts such as inter-group respect and team-building will be mindful of the activities of others within their care unit and will seek to give them positive responses when they have exceeded organizational policy or procedural expectations. Bringing these accomplishments up to senior-level administrators is another effort involved with using emotional intelligence as it would give the employee more exposure and make them feel self-confident about their contributions to successes in the division. In the 20th Century, psychologist Abraham Maslow developed what is today referred to as the Hierarchy of Needs, a model which shows the stages of emotional growth and needs that most people conform to. This model suggests that basic physiological needs must be fulfilled in order to consider higher elements such as security, self-esteem development, or social belonging. As one need is fulfilled, the individual moves up the tier until they reach their maximum self-performance capabilities and emotional maturity. A leader recognizes that issues of social belonging are very important for people to function well in teams and therefore works to build teamworking in every situation where it is appropriate. Part of being a quality leader with the ability to promote collaboration is reinforcing the value of the skills that each professional provides the team and then offers support for their concerns at the emotional level. Appealing to colleague or managerial needs at the social level is only going to build better self-confidence in team members and provide respect between all levels of the organization. How to best foster teamwork in the health care organization is very important because patient care cannot be successfully delivered without multiple staff interventions between one another and the pediatric patient. A nurse with strong leadership skills will recognize when team collaboration is beginning to breakdown, or social problems are developed because of disagreements to new health care reform-driven process changes. Rather than focusing on the problems with the new change system, it is a better strategy to use leadership skills to focus on what is right about the process to reinforce its benefits to avoid negative social discussion or lack of unity. Cultural Competence The Liaison Committee on Medical Education (LCME) has introduced a standard for cultural competence in relation to education: “The faculty and students must demonstrate an understanding of the manner in which people of diverse cultures and belief systems perceive health and illness and respond to various symptoms, diseases, and treatments” (aamc.org, 2005, p.1). Cultural competence is best described as understanding different cultural values and lifestyles of different socio-economic demographics and then applying these understandings to build better relationships with patients and with internal staff as well. In relation to health care reform, the current proposal is for expansion of Medicare to cover Americans at the age of 55 rather than 65 (Dennis, 2009). This will impose many changes and, since more Americans will now have access to health care, staff professionals will likely have more social and professional encounters with this age demographic who might have, before, postponed health care due to cost concerns. A nurse with emotional intelligence will recognize these cultural needs, research their relevance and foundation in different cultural groups, and try to relate at that level. As a pediatric nurse practitioner, cultural identification can include understanding the family dynamics of Middle-Eastern cultures or reading theory on different risk assessments conducted by various ethnic groups. Cultural competence is important for ensuring that patients have a quality treatment experience (for word-of-mouth) and also so that patients can experience less frustration and anxiety during their interactions with caregivers in the organization. Patient problems could include “limited English proficiency or different thresholds for seeking care or expectations about their care” (Betancourt, Green, Carrillo and Park, 2005, p.499). The emotionally-intelligent nurse practitioner will educate themselves, or volunteer for training on cultural competence, to provide a better delivery of health services to people of different ethnic or lifestyle backgrounds. As a pediatric nurse practitioner, children of multiple demographics are part of treatment and building understanding of how families interact and respond is important prior to addressing these groups. Further, with health care reform will come more access to health care by many different demographics, especially those with multi-cultural backgrounds. Again, the role of the pediatric nurse practitioner is to ensure quality delivery of care therefore a leader must understand certain cultural biases and stereotypes that exist in different groups and then use communications skills to de-emphasize negative cultural responses from patients and their families. Even in areas of efficiency in providing health care, being able to relate to multi-cultural demographics will only bring positive outcomes for the organization and all stakeholders. The Preferred Future The concept of a preferred future involves an idealized organization where leadership theory is practiced by everyone on the staff and everyone is constantly involved with quality improvement. Though this is unrealistic in a real-time health care environment, it is something that nurses and other stakeholders should strive for as part of a focus on continuous improvement. Nurses “must be emotionally-intelligent thinkers who can be creative and open to new possibilities that we have not thought of before” (Grossman and Valiga, 2009, p.138). This suggests innovation as part of the preferred future where everyone is given the opportunity to express their unique ideas, concepts or solutions on how to best improve total organizational efficiency and quality. The idea of creating a health care organization where free information and knowledge-sharing is exchanged would be the preferred future for the role of pediatric nurse practitioner. In order to develop this kind of system, it would have to start with the process of decentralizing the organizational hierarchy to move decision-making throughout the organization instead of being trickled downward from the highest levels. Nurses and other stakeholders respond well to autonomous working environments where their ideas are actually applied to ongoing improvement programs. Even at the divisional level, decentralizing authority between physicians and nurses would create more job satisfaction and invite more positive social discussion by removing layers of authority. Motivating physicians and nurses to be more dedicated caregivers is of critical importance to the organization and all of society’s stakeholders who periodically require medical expertise and treatment. The preferred future in the role of pediatric nurse practitioner would be one where people recognize that “different stakeholders have different informational needs” (ahrq.gov, 2009, p.1). The goal of a leader in this role would be to informally interview others on the staff to find out what their concerns or frustrations are and then working to minimize these distractions at the colleague level. These interactions will show colleague concern and reinforce that health care delivery is a team effort where interpersonal interactions are very important to unit success. Applying Learning to Pediatric Nursing The changes which are being proposed by health care reform initiatives will definitely make operational and policy changes in the organization over time. This will impact all types of nursing, including pediatric nursing, whether at the cultural or internal processes level. Recognizing that there are going to be some stakeholders who are resistant to these changes is the first step to idealizing the preferred future of knowledge-sharing and team unity. Being able to combat any emotionally-driven or process-driven frustrations that arise will involve being a diplomat and taking control of the situation through negotiation and collaborative discussion. Children are the concentrated focus of health care in this position and anyone involved within the system that is dedicated to enhancing quality of service must remain professional and show discretion with their personal concerns. As a leader in the future role of pediatric nurse practitioner, this will always be a major focus to ensure that youths feel security, belonging, and self-confidence about treatment and their in-house experience at the organization. Health care reform is likely going to bring more of a patient load as more Americans will have access to health care. The preferred future is one where cultural competence is taught in foundational training once landing a position within the organization so that there are no discrepancies or even liabilities which occur because of poor cultural communications between patient and caregiver. The role of pediatric nurse practitioner requires considerable patient simply by design and its connection with youths, and higher patient loads and responsibilities will create frustrations of many different varieties. However, lessons learned about emotional intelligence and being able to control the self and analyze regulation of personal responses to crisis or frustrating situations will be a key role in being a success as pediatric nurse practitioner. References Aamc.org. (2005). “Cultural Competence Education. Association of American Medical Colleges. Retrieved December 5, 2009 from http://www.aamc.org/meded/tacct/culturalcomped.pdf. Ahrq.gov. (2009). “Setting the Agenda for Research on Cultural Competence in Health Care: Introduction and Key Findings”. Agency for Healthcare Research and Quality. Retrieved December 5, 2009 from http://www.ahrq.gov/research/cultural.htm Betancourt, J., Green, A., Carrillo, E. and Park, E. (2005). “Cultural Competence and Health Care Disparities: Key Perspectives and Trends”. Health Affairs, 24(2), pp.499-505. Retrieved December 6, 2009 from http://content.healthaffairs.org/cgi/content/full/24/2/499. Dennis, Denise. (2009). “Health Care Reform: Compromise or Compromised. Retrieved December 7, 2009 from http://www.huffingtonpost.com/denise-dennis/health-care-reform-compro_b_385310.html Grossman, S. and Valiga, T. (2009). The New Leadership Challenge: Creating the future of nursing. 3rd ed. FA Davis Company, pp.66-67, 138. Read More