IOM1 Task 1: Personal Mastery Scenario-Based Solver Projects
During my clinical shift, a patient, Mr. Dan, got enraged and attacked the caregiver. The caregiver was trying to give him medications. The patient was very uncooperative and did not want anything to do with the caregiver. The caregiver was angry with the client and could not initiate therapy or care interventions. There was shouting from the client and caregiver, and no communication was possible.
The patient complained that he did not understand why he was kept in a mental hospital, yet all he had wanted was to be with his family. The patient was an army serviceman on active duty diagnosed with PTSD. He had been brought to the facility due to anger issues and quickly starting fights with co-workers.
He had injured his supervisor after being denied an off after spending more than four months on active duty without a break. The pressure and work stress had gained on him. The situation required quick action because of the patient’s history and the risk to
Problem statement: “The patient complained that he did not understand why he was kept in a mental hospital, yet all he had wanted was to be with his family.”
The skill required for this scenario is social awareness. Patients’ actions are affected by various factors, including past experiences, and care providers must appreciate the diversity between patients (Castelino et al., 2021). Social awareness as a social-emotional skill helps individuals to be aware of other people’s emotions and experiences and the influences of factors such as culture and environment on individual decisions.
Social awareness helps appreciate everyone and their uniqueness and also helps nurses implement it. The skill also allows for fair treatment of others. Listening to this patient explain his problems can facilitate decision-making. Using this skill would have helped understand the reason for the discomfort and also establish things that would have been done to ensure the patients’ comfort.
Listening to this patient’s problems would ensure a deep understanding of them and their effective management. Understanding the reasons for admission after the nurse has explained would solve the situation effectively and allow for medications and other care intervention delivery.
The personal strength necessary in this scenario is active listening. I actively listen and give remarks where necessary and can also outwardly show the clients that I am actively listening. The strength helps ensure patients or other care providers feel they are taken seriously and their views considered hence better collaboration. Empathetic listening was the selected communication strategy for this patient. The strategy helps the parties air their grievances or viewpoints for consideration in communication (Tobase et al., 2021).
Empathetic listening entails asking the client and the caregiver to each express themselves and show concern. The strategy helps the parties see that you care, which improves their participation in care delivery and increases the chances of making an effective decision that is fair to all. The patient needed to be explained why he was kept in the hospital because he calmed down after explaining the reason for admission and the goals of admitting him to the psychiatric ward.
Mr. Keith, a nurse, and a patient’s relative, Mr. Harris, got into a heated argument after the relative was disallowed to see his relative in the psychiatric ward because he arrived forty-five minutes past the agreed visiting time. The nurse held onto the current local, state, and national policies regarding seeing patients due to the disruption of current nursing and other healthcare activities.
The nurse held that allowing him into the ward would impede other working activities and be unfair to other guardians who were denied entry past the allowed time. In contrast, the relative held that he had driven five hours to see the patient, and denying him entry could be very unfair to him.
The heated argument was beginning to attract a crowd among the care providers and the patients, and there was a need to intervene. Some were supportive of the nurses’ actions, while others questioned the decision because, to them, it was easy allowing the relative in the ward past the allowed time.
Problem Statement: The nurse held that allowing him into the ward would impede other working activities and be unfair to other guardians who were denied entry past the allowed time. In contrast, the relative held that he had driven five hours to see the patient, and denying him entry could be very unfair to him.
The social and emotional skill required was responsible decision-making. Healthcare professionals should be responsible in decision-making as an essential step in ensuring they achieve their goals and targets. Grace and Uveges (2022) note that responsible decision-making ensures justice and fairness and that the nurses can defend their decisions logically.
In this scenario, there are existing rules that the nurse can play by strictly, which state that patient relatives are not allowed in the ward past the visiting hours. However, the circumstances surrounding this request may warrant being allowed to visit the relative.
Allowing the relative some time may break the rules but brings satisfaction to the nurse, patient, and relative because allowing the relative to briefly see the patient does not affect work significantly but helps rekindle a good nurse-family relationship. The act can also facilitate other care interventions, such as knowing the patient’s progress and availing necessities such as drugs that the patient may need.
Negotiation skills are my strengths that could facilitate the management of this scenario. Negotiation will help ensure the nurse and the relative agree and meet at a common ground. The decision came from compromising the current laws and regulations and allowing the relative the minimum time possible to be with the patient.
Väyrynen (2019) notes that negotiation skills help build relationships and agreements and thus allow individuals to solve hard decisions and ensure the decisions are made. Shared decision-making would be the selected communication strategy of interest. Understanding how far each party was willing to compromise their decisions (Coronado-Vázquez et al., 2020) was important.
The situation was rather unfortunate because, going by the rules, the relative was strictly not allowed in the ward. The primary reason for such policies is to ensure that the nurses are in full control of the wards and that their daily activities, such as medication administration, are not interfered with. Shared-decision making ensured all parties involved were comfortable with the decision.
During my shift, a psychiatric patient, Mr. Kelvin, who had been considered for possible discharge, came to the office to request an early release. The discharge plans and decisions were inconclusive, so he could not go home. The patient started an argument, even insulted me, and attempted to assault me, claiming I was of no use to them because I refused to give in to their demands.
All attempts to de-escalate the situation were futile, and the patient was uncontrollable and had to be locked in isolation to facilitate his cooling down. The following day, the charge nurse assigned me new patients, including the patient we had a conflict the previous day. We had an argument and a poor working relationship. The flawed relationship between the patient and me could have affected care delivery, and there was a need to intervene to ensure quality outcomes.
Problem Statement: The flawed relationship between the patient and me could have affected care delivery, and there was a need to intervene to ensure quality outcomes.
Self-Awareness was the social and emotional skill required in this situation. In this situation, I needed to be aware of my emotions to prevent them from affecting my decisions. To solve the situation, asking for a change of clients from the charge nurse was necessary to ensure that my care delivery and practices were not affected by our poor work relationship with the clients.
Also, seeking reconciliation help from the charge nurse would be necessary. Nurses’ attempts to solve problems may be prejudiced, and patients may dislike someone for no good reason. These two interventions would ensure that care delivery to the patients is not affected and that the nurse-patient relationship is not severed further.
Being self-aware of one’s emotions allows the nurse to make decisions that affect the quality-of-care decisions. According to Rasheed et al. (2019), a poor nurse-patient relationship affects care delivery and patients’ self-reported healthcare experiences.
This scenario required self-awareness and inquiry, and confidence were personal strengths required and used for this case study. Speaking up to the charge nurse and requesting the changes is a bold step that is necessary to help facilitate care delivery and produce quality outcomes.
Self-awareness also helps an individual confront uncomfortable situations and prevent mishaps that could have been worse than confronting the current problem (Rasheed et al., 2019). Shared decision-making was necessary at this point. Shared decision-making is critical for patient management and allows every party to be heard and the decisions to be in favor of everyone (Coronado-Vázquez et al., 2020). The clients’ perspectives on the being assigned to me were necessary to ensure the decisions made considered it. The strategy was necessary to enhance success in care delivery.
Mr. Kevin kept complaining to the nurses that he wanted to go home. He has been diagnosed with Schizophrenia, and too often, he would throw his items in the air, which made other nurses lock him up in isolation several times. During my shift, the client had one of those anger outbursts, cursing names with anger written all over his face.
He seemed angry and frustrated for some reason, and I was determined to find out and remedy the course. I approached him, and we had a conversation. He was hostile at first, but I made it clear to him that all I wanted was to help him. Mr. Kevin said he was uncomfortable because the room did not feel like him, and most of the items he cherished were unavailable.
Most of the items, such as the bible, stress balls, and favorite notebook, could be brought to him, but others,r such as his dog pet, were difficult to secure. During the conversation, I actively listened and saw him brighten and increase his social interaction, minimizing the initial hostility.
Problem statement: Mr. Kevin said he was uncomfortable because the room did not feel like him, and most of the items he cherished were unavailable.
Self-Management and Self-awareness are critical for this scenario. Self-management helps create goals and deal with self-emotions before working with clients. Self-awareness helps manage self-emotions and avoid prejudice when dealing with clients from all cultures and backgrounds (Castelino et al., 2021).
Self-management also helps control impulses, implement self-discipline, and help set and work towards goals. The common goal here is to make the patient comfortable, and the patient must also participate in goal setting. Reviewing the hospital policy and discussing the patient’s demands with the clients can help avail these items and improve patient comfort.
Some acts may be little, but when available, some or all of these items might help calm the patients. It is also vital to undervalue the sentimental value of some of these items and focus on promoting comfort in this patient to promote their care collaboration even in other care interventions.
Personal strength significant to this satiation is politeness. Empathetic listening is an important communication strategy that would be used to manage this situation. The patient is desperate to be listened to and claims she is unjustly treated. Reassurance and concern may help calm the patient and eliminate negative emotions.
Empathetic listening is a welcoming strategy that builds relationships, understands the patient’s genuine concern, and intervenes accordingly (Tobase et al., 2021). Making the patient comfortable is the ultimate goal. Shared decision-making is also crucial in this scenario.
It entails discussing the situation with the patient to ensure they reach a common agreement. The patient’s perspectives will guide the next actions because they will consider the patients’ demands and what the nurses can comfortably do.
Ms. Joyce, a relative of one of the psychiatric ward’s patients, called the office complaining about the restrictions of not being allowed to see their relatives. Based on the recent policies at the time, the relative could not see the patients at the facility. The relative complained that healthcare providers all go to work with the patients and return to their families but deny the patients a chance to be with their families.
The relative was angry and started with a hostile and unwelcoming demeanor. She was yelling with dissatisfaction and agony for not seeing her brother for some time despite the brother being sick. It was a difficult situation because she had not seen her brother for two weeks, and every attempt to see her brother had been blocked every single time with limited explanation.
She was angry and complained that the care provider was rude ad dismissive, and she was bitter in her voice. This time the relative was determined to see her brother no matter the barriers, even if it meant breaking the current policies. The client was enraged, managing this situation was difficult, and an intervention was necessary. Keeping up the conversation and listening to her allowed her to express their emotions which saw the patient slowly becoming more and more welcoming to a conversation.
Problem Statement: “The relative was angry and started with a hostile and unwelcoming demeanor, and was yelling with dissatisfaction and agony for not seeing her brother for some time despite the brother being sick.”
Social awareness and relationship-building skills were necessary for decision-making in this scenario. Nurses must establish good relationships with relatives and patients to facilitate care delivery (Castelino et al., 2021). There is a need to show empathy to this patient and create a good friendship to ensure the family member understands the position of the healthcare providers, the policies, and their significance.
There is also a need to understand their arrogant remarks and ensure they do not affect personal emotions because they may interfere with conversation building. The relative lacks an understanding of the effects of policies developed at the state and national levels and how care providers at the local level may not affect the change of these policies.
She also needs to understand that patients are kept in the hospital for health reasons, care providers risk their lives as they provide services, and they also have protective gears that may not be available to the public. Creating a good relationship with the client is important to help her understand this information. Social awareness will help listen to the patients, understand the reasons for the remarks, and empathetically address them.
Personal strengths that would be used in this case are politeness, empathy, and sincerity are required for this situation. Wu (2021) states that nurses’ politeness helps de-escalate the situation and ensure common ground or agreement between the parties involved.
Empathy also supports the relationship-building process because perceiving that the other person cares helps deal with negative emotions such as distress, anger, and dissatisfaction (Tobase et al., 2021). Sincerity increases trust, and going further to provide evidence for the information discussed can help calm the relative and help work out a solution together.
Active listening, acknowledging other people’s concerns, and failure to interrupt are the chosen communication strategies in this difficult conversation (Bullington et al., 2019). It is one of the communication strategies that promote quality decision-making because it helps parties understand each other and the basis for each party’s decisions.
Active listening will help understand all the relatives’ grievances which would help intervene. Acknowledging concerns helps build a relationship because relationships help make decisions that favor both parties. Lack of interruption when an individual is talking shows that you are concerned about them and their concerns. It thus increases trust in the explanation or reasons for actions taken. These strategies support social awareness and relationship building hence their significance.
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Castelino, P. S., & Mendonca, T. L. (2021). Emotional Intelligence in Nursing: the heart of the art–a review. Journal of Complementary and Alternative Medical Research, 14(3), 1-6. https://doi.org/10.9734/jocamr/2021/v14i330244
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