peer advocacy
You are a nursing student. Like many of the students in your nursing program, sometimes you feel you study too much and therefore miss out on partying with friends; something many of your college friends do on a regular basis. Today, after a particularly grueling exam, three of your nursing school peers approach you and ask you to go out with them to a party tonight, off campus, which is being co-hosted by Matt, another nursing student. Alcohol will be readily available although not everyone at the party is of legal drinking age, including you and one of your nursing peers (Jenny). Because you really do not want to drink anyway, you agree to be the designated driver.
Almost immediately after you arrive at the party, all three of your nursing peers begin drinking.
At first it seems pretty harmless, but after several hours, you decide the tenor of the party is changing and becoming less controlled, and that it is time to take your friends home. Two of your peers agree, but you cannot find Jenny. As you begin searching for her, several partygoers tell you that she has been drinking “kamikazes” all night and that she “looked pretty wasted” the last time they saw her. They suggest that you check the bathroom since Jenny said she wasn’t feeling very well.
When you enter the bathroom, you see Jenny slumped in the corner by the toilet. She has vomited all over the floor as well as her clothing and she reeks of alcohol. When you attempt to rouse her, her eyelids flutter but she is unable to wake up or answer any questions. Her breathing seems regular and unlabored, but she is continuing to vomit in her “blacked-out” state.
Her skin feels somewhat clammy to the touch and she cannot stand or walk on her own. You are not sure how much Jenny actually had to drink or how long it has been since she “passed out.”
You are worried that Jenny is experiencing acute alcohol poisoning but are not very experienced with this sort of thing. The other two nursing students you brought to the party feel you are overreacting, although they agree that Jenny has had too much to drink and needs to be watched. One of your peers suggests calling the new young, clinical instructor in the nursing program, who offered just the other day to provide rides to students who have been drinking.
You think she might be able to provide some guidance. Another one tells you that she feels Jenny just needs to “sleep it off” and that she will stay with Jenny tonight to make sure she is OK, although she has had a fair amount to drink herself.
You think Jenny should be seen in the local emergency department (ED) for treatment and are contemplating calling for an ambulance. One partygoer agrees with you that Jenny should be seen at the hospital but suggests you drop Jenny off anonymously at the front door of the ED so “you won’t get in any trouble.” Matt encourages you not to take her to the ED at all, because he is afraid the incident will be reported to the local police since Jenny is a minor and that he could be in “real trouble” for furnishing alcohol to a minor. He argues that this could threaten or a living will should he become unable to make his own health-care decisions. Today, Sam takes you aside and suggests that “he wants to fill out this paperwork so that no extraordinary means of life support are used,” and he “wants you to witness it so that his wife will not know.”
assignment: Decide what you will do. What is your obligation to Sam? To his wife? To yourself?
Whose needs are paramount? How do the ethical principles of autonomy, duty, and veracity intersect or compete in this case?
(Continued )
reFereNces
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both his progression and Jenny’s in the nursing program. He says that she can just stay at the house tonight and that he will check in on her on a regular basis.
To complicate things, you, Jenny, and the other two students you brought to the party live in the college dormitories and they lock down for the evening in another 30 minutes. It will take you at least 20 minutes to gather the manpower you need to get Jenny down to your car and up to her dormitory room by lockdown, if that is what you decide to do. If you are not inside the dormitories by lockdown, you will need to find another place to spend the evening. In addition, there will likely be someone at the door to the dormitory assigned to turn away students who are clearly intoxicated.
assignment: Decide what you will do. How do you best advocate for a peer when they are unable to advocate for themselves? Does it matter if the risk is self-inducted? How do you weigh the benefits of advocating for one person when it can result in potential harm or risk to another person?
Roles and Functions in Planning
UNIT III
138
Strategic and Operational Planning
… in the absence of clearly defined goals, we are forced to concentrate on activity and ultimately become enslaved by it.
—Chuck Conradt
… he who fails to plan, plans to fail.
—Anonymous
CROSSWALK
this ChApter Addresses:BSN Essential II: Basic organizational and systems leadership for quality care and patient safety BSN Essential III: scholarship for evidence-based practice
BSN Essential V: health-care policy, finance, and regulatory environments BSN Essential VIII: professionalism and professional values
MSN Essential II: Organizational and systems leadership
MSN Essential IV: translating and integrating scholarship into practice MSN Essential VI: health policy and advocacy
AONE Nurse Executive Competency II: A knowledge of the health-care environment AONE Nurse Executive Competency III: Leadership
AONE Nurse Executive Competency V: Business skills QSEN Competency: teamwork and collaboration QSEN Competency: evidence-based practice
LEARNING OBJECTIVES
The learner will:l identify contemporary paradigm shifts and trends impacting health-care organizations
l analyze social, political, and cultural forces that may affect the ability of 21st-century health- care organizations to forecast accurately in strategic planning
l describe the steps necessary for successful strategic planning
l identify barriers to planning as well as actions the leader-manager can take to reduce or eliminate these barriers
l include evaluation checkpoints in strategic planning to allow for midcourse corrections as needed
l discuss the relationship between an organizational mission statement, philosophy, goals, objectives, policies, procedures, and rules
l write an appropriate mission statement, organization philosophy, nursing service philosophy, goals, and objectives for a known or fictitious organization
l compare the societal values regarding access to and payment of health care in the United states and at least one other country
l discuss appropriate actions that may be taken when personal values are found to be in conflict with those of an employing organization
l recognize the need for periodic value clarification to promote self-awareness
l describe personal planning style
7
Planning is critically important to and precedes all other management functions. Without adequate planning, the management process fails and organizational needs and objectives cannot be met. Planning may be defined as deciding in advance what to do; who is to do it;
and how, when, and where it is to be done. Therefore, all planning involves choosing among alternatives.
All planning involves choice: A necessity to choose from among alternatives.
This implies that planning is a proactive and deliberate process that reduces risk and uncertainty. It also encourages unity of goals and continuity of energy expenditure (human and fiscal resources) and directs attention to the objectives of the organization. Adequate planning also provides the manager with some means of control and encourages the most appropriate use of resources.
In effective planning, the manager must identify short- and long-term goals and changes needed to ensure that the unit will continue to meet its goals. Identifying such short- and long-term goals requires leadership skills such as vision and creativity, since it is impossible to plan what cannot be dreamed or envisioned.
Likewise, planning requires flexibility and energy—two other leadership characteristics.
Yet, planning also requires management skills such as data gathering, forecasting, and transforming ideas into action.
Unit III focuses on several aspects of planning, including strategic and operational planning, planned change, time management, fiscal planning, and career planning. This chapter deals with skills needed by the leader-manager to implement strategic and operational planning. In addition, the leadership roles and management functions involved in developing, implementing, and evaluating the planning hierarchy are discussed (Display 7.1).
DISpLAy 7.1 Leadership Roles and Management Functions Associated with Operational and Strategic Planning
LEADERSHIP ROLES
1. translates knowledge regarding contemporary paradigm shifts and trends impacting health care into vision and insights which foster goal attainment.
2. Assesses the organization’s internal and external environment in forecasting and identifying driving forces and barriers to strategic planning.
3. demonstrates visionary, innovative, and creative thinking in organizational and unit planning, thus inspiring proactive rather than reactive planning.
4. influences and inspires group members to be actively involved in both short- and long-term planning.
5. periodically completes value clarification to increase self-awareness.
6. encourages subordinates toward value clarification by actively listening and providing feedback.
7. Communicates and clarifies organizational goals and values to subordinates.
8. encourages subordinates to be involved in policy formation, including developing, implement- ing, and reviewing unit philosophy, goals, objectives, policies, procedures, and rules.
9. is receptive to new and varied ideas.
10. role models proactive planning methods to followers.
MANAGEMENT FUNCTIONS
1. is knowledgeable regarding legal, political, economic, and social factors affecting health-care planning.
2. demonstrates knowledge of and uses appropriate techniques in both personal and organiza- tional planning.
(Continued)