Skills for a Nurse Educator - Essay Example

Topic: Evidence based practice Introduction The present health care environment requires nurses and health care practitioners, to further their knowledge and skills to improve health care services provided to patients. Currently, most nurses are solely responsible for the proper development of their care giving schemes. Lack of well-established means of assimilation limits new graduate nurses into the health care industry. This properly imparts the necessary skills to them once they start working as nurses in hospitals. Furthermore, the demands for greater accountability have increased, amidst limited organizational resources. Training initiatives must both support lifelong education and prepare health care workers in undertaking their diverse roles and responsibilities in a timely, efficient, and effective manner. One of the most effective training methods that can be used, better, to impart the necessary skills in new nurses and other healthcare professionals is mentorship. This has proved highly effective in other professions and can also work well in healthcare. This paper will attempt to explore the steps and changes which will be needed to develop an evidenced based approach in clinical coaching and mentorship. Area OF Work The area of work is to act as a clinical educator in the segment of providing education to the new graduate nurses in one of metropolitan hospitals in Western Australia. The role is to develop, coordinate and implement a flexible learning program for nursing service personnel for undergraduate, new nurses and agency nurses. Another important profile of the work is to ensure that these new nurses adhere to all policies and guidelines of the facility and the Australian Nursing and Midwifery Council. This is for ensuring that the best and safe practices are maintained whilst they are involved in direct patient care. They need to be constantly supervised, taught and guided to be able to motivate them to deliver utmost and safe patient care. Individual’s skills and knowledge have to develop and improve to some aspect of personal behavior or professional performance. In this regard, the presence of a clinical educator or a staff development nurse plays a crucial role. The basis of this proposal has been designed by analyzing gained outlook from the work being provided as a clinical nurse educator. The necessity for an effective education program in nursing has been identified from the facts being observed during imparting teachings to these new nurses. As a coworker, of educating the new graduates to deliver an effective and safe nursing care to their patients, the barriers towards effective implementation of an effective staff development programs. With this notional belief being upheld and gaining insights from various relevant literatures to the topic, this area of research has been considered. There are reasons for an evidence based approach. Most nurses who are fresh from the graduate school find themselves confused and sometimes clueless on commencement of their tenure in healthcare institutions. They have the appropriate theoretical knowledge but lack a sense of how they should properly carry out their tasks as healthcare workers in these institutions. Hence there is a need to develop a proper evidence based program. This will ensure that the necessary and proved techniques in care giving are properly passed on to new nurses. Through observations and interviews with nurses, self-directed learning, which is often used in each hospital, is not highly effective in supporting the learning needs of these nurses. Many of them would only read the training manuals designed for them for compliance purpose, without fully understanding and utilizing the knowledge and skills that these manuals intend to teach them. This paper aims to design an effective education approach for nurses in the hospitals that could be effective in their workplace. An evidence-related approach will be used to design the education program for the staff. Skills for a Nurse Educator A registered professional nurse with an advanced education qualifies to be a Clinical Nurse Educator, including postgraduate clinical and educational training combined with several years of expertise in a healthcare specialty (Coe, n.d.). A combination of clinical expertise and a passion for teaching is two of the fundamental skills that are needed by nurse educators (March &Ambrose, 2010). Nurse Educators should have research and writing skills needed to identify learning needs and develop the right educational program and teaching strategies for their target learners (March & Ambrose, 2010). They should also have classroom where teaching skills, prepared to design and assess academically, and continuing education system for nurses and clinical staff (Coe, n.d.) are done. At the workplace, they design informal, continuing, education programs that aim to enhance professional competencies as part of the individual learning needs them. They should also have plenty of experience with what it entails to be a nurse in order to create a realistically achievable program. This will be seamlessly integrated into the nurses normal routine without clashing with it or causing unnecessary inconveniences, which would lead, to lack of acceptance of the program and ultimately to its inevitable failure. In addition, nurse educators serve as leaders who redefine processes for improved workflow, documentation of the results of educational programs and to assist staff, students and patients through the learning process (Coe, n.d.). Nursing teams work closely with patients and healthcare professionals to develop innovative approaches for patient management and enhanced disease outcomes. These range from training of professionals on new treatment protocols to working with health care workers and patients. Some managerial skills would also be required because the educator is essentially in some respects acting as a manager would, because of the large amounts of staff they are expected to handle. Why Choose Clinical Coaching AND Mentoring? Mentorship and coaching are some of the practices that could support an effective staff development program. It is evident that the hospital needs a competency-based approach that is appropriate to hospital policies and guidelines, as well as the Australian Nursing and Midwifery Council guidelines. In “Building Capacity for Evidence-based Clinical Nursing Leadership,” Alleyne and Jumaa (2007) aimed to help primary care nurses connect management and leadership theories and clinical practice, through group clinical supervision sessions, so that participants can develop their decision-making skills. Through executive coaching, participants were accomplished in learning systematically from the past; using evidence based clinical nursing leadership. Mentorship is also a growing educational approach in health care workplaces. Block et al. (2005) defined nurse mentorship as a relationship between two nurses, where trust and compatibility are significant, so that they can reach personal and professional objectives (p.34). They concluded that mentorship has sensible benefits for nurses and nursing organizations. Coaches facilitate a process of development or change which enables individuals and organizations to realize their potential. Potential is realized latent ability, capacity, or possibility. Consultation Process. In order to implement the evidence, based in health care institutions various parties had to be consulted. Healthcare institution administration and management had to give the evidence based approach their go ahead. The nurses involved too had to be informed of the change and asked for their cooperation. When consulting, with the nurses several issues should be raised. First, what do they think the evidence based approach should entail? Since the program is designed to help the nurses better ability to do their job, they have a lot of insight into what should be done. This is either from problems they have personally encountered or from problems they have seen their colleges encounter and in some cases just from observation. This will help them acquire the skills needed to do their work. Secondly nurses had to be consulted so as to come up with the obsolete curriculum to be followed. When the actual curriculum is developed, its actual implementation even though to some extent is predetermined by actual feedback required from the nurses in order to make any necessary changes. When consulting several issues also need to be raised with the healthcare institutions, since the management in the institutions is going to be responsible for the actual implementation of the staff development program they have considered things such as financing of the program. For the staff development, program to be implemented trained professionals have to be hired hence the need to raise the financial issue with the institution. Implementing the Mentoring AND Coaching Program It is evident that the hospital needs a competency-based approach that is appropriate to hospital policies and guidelines, as well as the Australian Nursing and Midwifery Council guidelines. In “Building Capacity for Evidence-based Clinical Nursing Leadership,” Alleyne and Jumaa (2007) aimed to help primary care nurses connect management and leadership theories and clinical practice, through group clinical supervision sessions, so that participants can develop their decision-making skills. Findings showed that, through executive co-coaching, participants were accomplished in learning systematically from the past, using evidence-based clinical nursing leadership. Mentorship is also a growing educational approach in health care workplaces. Block et al. (2005) defined nurse mentorship as a relationship between two nurses, where trust and compatibility are significant, so that they can reach personal and professional objectives (p.34).mentorship has become relatively popular in the healthcare industry over the last few years because of it proven benefits both to patients and caregivers. They concluded that mentorship has sensible benefits for nurses and nursing organizations. Coaches facilitate a process of change or development which enables individuals and organizations to realize their potential. Potential is realized latent ability, capacity, or possibility. Change, however, is not easy to implement. A change management program is also needed to implement the staff development program. This change development program will utilize the Lewin’s change model. This model defines the three-stage change model process, the stages of unfreezing, changing, and refreezing (Matthews, 2009, p.7).Unfreezing involves creating the need for changes; changing refers to pursuing in attitude and conduct and refreezing pertains to institutionalizing changes made (Matthews, 2009, p.7).Unfreezing pertains to the shakeup phase. It is the stage of identifying the existing problem in the workplace. This is to assess the change needed to decrease errors in the health care setting and enhances the professional competencies of the health care staff. The outcome is an acknowledgement that the already existing structure or structures and ways are not working to get people ready for Changes (Module Two, n.d., p.2).Concerned health care practitioners will be informed of the following aspects of change: Necessity of change, Change is needed in how health care workers are trained. It should shift from self-directed learning to mentorship and coaching practices. The primary changes include using more mentorship and coaching techniques in identifying and training required competencies for different health care workers. In the article “Mentorship in Nursing: A Literature Review” by Andrews and Wallis (1999), they studied mentoring literature in nursing practice. They recommended the use of “mentoring teams” instead of “supervisory” panels for postgraduate nursing students, and for mentors to receive official training in mentorship to improve their capabilities in responding to their students learning needs. Myall, Levett-Jones, and Lathlean (2008) and Ryan, Goldberg, and Evans (2010) agreed with these findings. Nature of change needed. The nature of change is educational in nature but requires changing attitudes and practices towards learning. Learning does not have to be mostly self-directed but use mentorship and coaching, which will mostly have to be at the beginning of one’s work at healthcare institution. Methods planned to achieve the change. The methods used to achieve change, are meant to prepare health care workers in the position to be coaches and mentors for nurses. Change management is also needed, which is already outlined in this section of the paper. Needs of those affected. The needs of the coaches and mentors are for them to have teaching, interpersonal, and communication skills for their new roles and responsibilities. Myall, Levett-Jones, and Lathlean (2008) examined the purpose of mentorship in nursing practice using British and Australian case studies. Findings showed that mentorship is essential to pre service nurses and that mentors need formal training as educators. Students also felt the connection between the quality of mentorship and their connection with their clinical areas, which helped them have a deeper form of learning. Methods that progress will be planned and supervised. Progress will be monitored through observation and surveys on the satisfaction and learning/teaching needs of Students/coaches/mentors. Change pertains the process of designing and implementing it. Define the problem. The problem is that self-directed learning is time-efficient, but not effective in teaching health care practitioners the competencies they need to perform their wide roles and responsibilities. They need coaches and mentors to help them develop and improve their professional competencies. Identify solutions. The solution is through mentorship and coaching, where appropriate. Haidar (2007) used a case study research to show why mentors should recognize the theories and approaches to mentorship. Findings demonstrated that mentorship benefits mentors, students, and general care. Mentoring teams are better than single mentors, because no mentor can successfully serve all the purposes of mentorship. Teaching styles must reproduce the learning styles of students. Mentors can use usual models to determine and reach goals, such as the Specific, Measurable, Attainable, Realistic, and Time-bound (SMART) model. They should be conscious of the mentee stages of their students; proper communication is crucial to mentorship and mentors should embark on reflection and analysis of feedback. Coaching promote professional growth and facilitate knowledge, attitude, and skills changes (Locke, 2008, pp.103-104). Devise appropriate strategy to apply the change. The proper strategy is to use communication and participation to reduce resistance to change. Locke (2008) underscored the significance of developing leaders as coaches, which is critical to this program. First, the nurse educator will collect ideas, feelings, and opinions from possible mentors/coaches and learners, about the competencies they need make on improvements. Second, she will develop the program that will help mentors/coaches in enhancing the competencies of target learners. The nurse educator can also act as coach/mentor for her own specialty. Implement solutions. Solutions will be implemented in an incremental manner, so that resistance to change can be reduced. Refreezing pertains the momentum of change and the process of maintaining it. Securing in the changes. Changes will be locked in through evaluation and sharing learning outcomes and other success factors. Some of the most effective ways of locking in changes include introducing policies on the changes made and adequately enforcing this policies Building relationship. Relationship with mentors/coaches and learners must be constantly developed and nurtured. Their feedback and suggestions should help improve upcoming staff development programs stabilizing the situation. Stabilization can be attained through institutionalizing the program through organizational policies and procedures. This involves coming up with policies within the institution to target the actual areas the program has changed. With reference to several cases, a lot of individual testimonials in scores of firms, and various threads of research, training has an immensely positive impact on business results people. Coaching effectively enables people improve their performance in areas of cognitive skills, communication, interpersonal, and leadership than management training. Studies (summarized in Kampa& White, 2002; Kampa- Kokesch & Anderson, 2001) provide substantial evidence that well designed coaching makes a meaningful difference in skill learning, job performance, and organizational results. As coaching professionals, we should design methodologies based on these three concepts. Best available knowledge Practitioner expertise Client preferences Levinson et al. (1978) were the first educators to study outcomes of mentorship. Their findings include the importance of the mentor’s believing in the mentee, sharing parts of the mentee’s dream, and sharing the dream his or her blessing. By doing this, they feel it helped to “define the mentee’s newly emerging self” (p.98). The psychosocial theory of development (Erikson, 1963) suggests that the final stage of generative correlates with the concept of mentorship since it allows all who have the will on improving the world to participate by the mentorship of younger generations. In academia, the framework suggested by (Luna and Cullen, 1996) fits in so well, where senior faculty mentor junior faculty to develop younger colleagues’ talent and, at the same time promote the department and the university, as well. Essentially generative is “the building block of mentorship as one gives back or mentors a new generation” (Luna & Cullen, p18). A.Roberts (200) carried out a literature review of mentorship using a phenomenological approach. He defines mentorship as “a process whereby a more experienced and knowledgeable person takes on a supportive role of overseeing, learning and encouraging reflection with a less experienced and knowledgeable person, so as to assist that person’s career and personal growth” (p.162). Results of his literature review on mentorship research published between 1978 and 1980 shows a consensus regarding the following themes as being components of the mentorship process: Helping process, supportive relationship, teaching learning process. Management of Resistance to Change. Marquis and Huston (2000) contended that because change can upset the “homeostasis, or balance, within a group resistance should always be expected.” The intensity of resistance will depend on the change. Since this paper involves changing attitudes and practices in learning, there will be moderate to high resistance, not because health care workers do not intend to improve their competencies, but because of the changes needed in the learning and work environment. Harvey (1995) asserted “change without resistance is no change at all-- it is an illusion of change.” Nurse educators should be able to recognize resistance and plan and execute strategies to reduce or prevent it (Curtis &White, 2002, p.15). Resistance to change pertains to any employee’s behavior in question, delay or averts the implementation of a work change (Curtis & White, 2002, p.15). Employees may oppose change for several reasons, mostly the reasons for opposition to change are natural and easily identified and understanding them can assist change agents in executing changes more effectively (Curtis & White, 2002, p.15). In other cases reasons for resistance to change may be not be as easily identified or understood. Strategies for reducing resistance are discussed. First, introduce changes slowly. Radical changes often meet the greatest level of resistance. Also, in changing something slowly, people who will be affected and are involved in the change can have enough time to think on the significance of these changes to their jobs and organizations (Curtis & White, 2002, p.18). In understanding the need for change and accepting it the process of change becomes smoother. Nurse educators should elicit the participation of most if not all concerned stakeholder. Participation can be the most effective strategy for lessening or overcoming resistance to change (Curtis & White, 2002, p.18) resistance even by one stakeholder may cause enough friction to bring the whole process of change to a halt. Third, nurse educators should develop psychological ownership for the change program (Curtis & White, 2002, p.18). Psychological ownership is a crucial theory to reducing psychological resistance to change (Curtis & White, 2002, p.18). It pertains to a feeling of being psychologically connected to an object/organization and having a sense of possessiveness for that object organization (Dirks et al., 1996 cited in Curtis & White, 2002, p.18). This theory asserts that there are three fundamental self-needs: “self-enhancement, self-continuity and control and efficacy” (Curtis & White, 2002, p.18). Individuals may be less likely to oppose change when it is “self-initiated, evolutionary and/or additive” as these kinds of change does not undermine fundamental self-needs (Curtis & White, 2002, p.18). Fourth, educating people about the need for change and its possible benefits is highly significant and helps to diminish resistance. ) Education helps shed light into misconceptions which might be causing resistance in the change and helps clarify on issues not initially understood. Fifth, trust should also be developed. This can be attained through, and honest communication throughout the change process all forms of communication should be encouraged whether positive or critical in nature in order to truly nature trust. Sixth, providing additional support is also critical, such as extra education, extra staff during the training period and decrease of workload during the change process (Curtis & White, 2002, p.18. Also, when implementing the change, there should be clearly stated short term and long term goals. Working towards short term goals give’s a sense of accomplishment and on something achievable. Long term goals, on the other hand, ensure that all the parties involved do not loose glimpse of what they are eventually working towards. This will help not settle for the short term success. Also, creating a sense of urgency will also help towards implementing the changes needed. When a sense of urgency is created the parties involved tend take more notice of the changes. This awareness of the change eventually causes the needed changes. Finally, consider the feedback provided by the parties and make any necessary changes. Conclusion. The change needed in the organization is to adapt mentorship and coaching in producing an effective staff development program using the best evidence-based practice. Some of the strategies applied in management consist of open communication and participation of learners and mentors. This paper discusses the unfreezing, changing, and refreezing actions for the program. This program aims at offering practical solutions to diverse learning. The needs of health care workers and to implementing feasible teaching strategies are also applied. References Alleyne, J. &Jumaa, M.O. (2007).Building the capacity for evidence-based clinical nursing leadership: The role of executive co-coaching and group clinical supervision for quality patient services. Journal of Nursing Management, 15 (2), 230-243. Andrews, M. & Wallis, M. (1999). Mentorship in nursing: A literature review. Journal of Advanced Nursing, 29 (1), 201-207. Australian Nursing and Midwifery Council (ANMC).(2005). National Competency Standards for the Registered Nurse. Retrieved from http://theses.flinders.edu.au/uploads/approved/adt-SFU20100708.110421/public/09Appendix7.pdf Block, L.M., Claffey, C., Korow, M.K.., & McCaffrey, R. (2005). The value of mentorship within nursing organizations. Nursing Forum, 40 (4), 34-140. Coe, S. (no date).The expanding role of the nurse educator. Retrieved from http://www.nursetogether.com/tabid/102/itemid/1478/The-Expanding-Role-of-the-Nurse-Educator.aspx Curtis, E. & White, P. (2002).Resistance to change. Nursing Management-UK, 8 (10), 15-20. Haidar, E. (2007). Coaching and mentoring nursing students. Nursing Management, 14 (8), 32-35. Harvey T.R. (1995). Checklist for change: A pragmatic approach to creating and controlling change (2nd ed.). Lancaster PA: Technomic Publishing Inc. Locke, A. (2008). Developmental coaching: Bridge to organizational success. Creative Nursing, 14 (3), 102-110. March, K.S. & Ambrose, J.M. (2010). Rx for NCLEX-RN success: Reflections on development of an effective preparation process for senior baccalaureate students. Nursing Education Perspectives, 31 (4), 230-232. Marquis, B.L. & Huston, C.J. (2000). Leadership roles and management functions in nursing: Theory and application (3rd ed.). Philadelphia PA, Lippincott. Mathews, J. (2009). Models of change management: a reanalysis. ICFAI Journal of Business Strategy, 6 (2), 7-17. Module Two Change Management Theories & Models. Myall, M., Levett-Jones, T., &Lathlean, J. (2008). Mentorship in contemporary practice: The experiences of nursing students and practice mentors. Journal of Clinical Nursing, 17 (14), 1834-1842. Ryan, A., Goldberg, L., & Evans, J. (2010). Wise women: Mentoring as relational learning in perinatal nursing practice. Journal of Clinical Nursing, 19 (1/2), 183-191. Read More