Villarruel, Lecher & Carver
- Based on the state and national success stories highlighted in Villarruel, Lecher & Carver,2015) and global initiatives noted in the Rosa, Upvall, Beck & Dossey, 2019 article:
- What 2 suggestions do you have to initiate/promote diversity programs in your state or local area?
- Describe how these two suggestions align with the ANA Position Statement, The Nurse’s Role in Addressing Discrimination: Protecting and Promoting Inclusive Strategies in Practice Settings, Policy, and Advocacy?
- Schmidt, MacWilliams and Boylen(2016) propose a Code of Conduct for Inclusion and Diversity. Which 2 of their proposed nurse behaviors can you pledge to include in your personal nursing practice? How will these behaviors improve inclusivity in your workplace?
The two behaviors from the article Becoming Inclusive: A Code of Conduct For Inclusion and Diversity by that I can pledge to include in my nursing practice are, involve others as partners in decision making and support the rights of others to make choices for themselves, and actively listen without interrupting imposing own opinions. I believe these behaviors improve inclusivity at my workplace because by carrying out these actions, patients and families feel that they are being included in their plan of care and feel comfortable speaking up when they don’t agree with a treatment being ordered for them. Recently on my unit we had a patient with advanced breast cancer who was given at best three months to live if we gave her every treatment option we had to offer. There was a lot of back and forth between the patients family and the care team because they didn’t understand that the patient was given a terminal diagnosis and the patients husband had a cognitive impairment so he couldn’t fully process what was going on. They were very confrontational every time a provider tried to suggest anything to make the patient more comfortable. The night before the patient passed, I spent quite a bit of time speaking to the family at the patient’s bedside, listening to all of their concerns and beliefs with out judgement or imposing my own opinions. When they finished voicing their concerns, I acknowledged that their concerns were valid, and also explained that by continuing on the trajectory that we were on was just going to make the patient more uncomfortable. She was starting to show signs of terminal agitation and was very tachypneic and was maxed out on high flow oxygen. She couldn’t move because she couldn’t breathe. I spent quite a bit of time explaining each medication that the provider had ordered to make the patient more comfortable and that we would slowly introduce them in order to monitor the patient’s reaction to them and make the family more comfortable. I also explained that by introducing these medications the patients breathing would become more comfortable and that when we got to this point, it would be time to ween the oxygen. The family was opposed to this because they felt it would suffocate the patient. I let them have this belief and the plan was to slowly introduce medications and go from there. Through open communication we were able to get the family to agree that every time we increased the patients morphine drip, we would turn the oxygen down until it was completely off. In doing so, the family was able to see that the patient was actually suffocating more the less we did.
- Review the 2021 Future of Nursing 2020–2030: Charting a Path to Achieve Health Equityreport offers 9 recommendations for the nursing profession.
- Which 2 of the recommendations do you support most to help achieve health equity? Explain.
The two recommendations that I believe will make the biggest difference in achieving health equity are, supporting the health and well-being of nurses, and preparing nurses to respond to disasters. I believe these are the most important because I have seen firsthand what happens when these things don’t happen. I have worked on the frontlines on a full covid unit. I have also felt the burnout and fatigue that comes from being forced to wear full personal protective equipment for twelve hours at a time with very little support from the people making these rules. I have also seen what happens when nurses are not listened to and do not feel supported. They eventually get burnt out and leave-sometimes the profession completely. I believe that if nurses are not better supported and there is not better planning that goes into preparing nurses to respond to global disasters, we are soon going to end up with a profession that is nonexistent. As the article states, “It is essential to address the systems, structures, and policies that create workplace hazards and stresses that lead to burnout, fatigue, and poor physical and mental health”. One action I would take to help achieve these two recommendations, now that I feel I have more of a voice with my new charge nurse role, is to push for more nurse involvement when it comes to putting together policies that effect how nurses take care of patients and the environment that they work in. I would also suggest that my hospital put together a wellness program in order to support nurses who are struggling with burnout, fatigue, and poor mental health. On my floor, I was involved in putting together what we call our lavender room. It is essentially what other hospitals would call a code lavender, just on a smaller scale. Code lavender was first developed by the Cleveland Clinic. It is a holistic care rapid response program to help caregivers in need of a calming influence after a stressful situation. It usually consists of support from chaplains, social workers, and staff from employee assistance programs. What this looks like on my unit is a quiet dark room with massage chairs, salt lamps and calming music. It is a room where people can go and decompress. I would suggest that we take our lavender room a step further and actually adopt the concept of a code lavender hospital wide. I think it would not only help with burnout and fatigue, but it would also help staff feel more supported and that they are not alone when it comes to facing difficult situations in the hospital setting.
- What 2 actions could you take to help achieve these 2 recommendations?
- Explain how these actions would help achieve health equity in your community.
