Sign Virginia Assignment of Partnership Interest Simple

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Hey guys this is Tammy and today we are talking about nursing competencies. What are they? How do I write to them? and how do I pass these darn things in so I get successful every time I talk to my instructor or my regulatory body? We'll talk about that right after this. Welcome back my name is Tammy and this is NurseMinder and on this channel we do everything nursing so if you're new here consider subscribing below so that you get the next video when it's released. Alright ladies and gentleman, we are talking about CARNA competencies today, I'm from Alberta so we call them CARNA you might be BC, Saskatchewan, maybe or from the states. You do likely have a document that outlines those entry to practice expectations of where your knowledge and skills that would be depending upon the patient population in which you're working with and we call those competencies. Now sometimes you're introduced to, you are introduced to them first when you're in school and every time you go to clinical, and sometimes in labs, you're having to write how what you're learning and doing actually applies to a particular competency and so there these are just kind of like overarching principles that there's an expectation that we have an awareness of and if we don't know the skill or the competency itself that we know how to access the content right. So it looks at lifespan, it looks like all different populations, it is evidence based, we are also looking at not just the patient but families and groups of people and society as a whole. So these competencies are really foundational to the practice of Nursing and so for us in Alberta they've just actually got a massive undertaking and they've restructured it so we now have nine core columns or core areas of competencies that we would address on a regular basis. So for us it's every year but I have a teacher and so my students also have to do this. I want to share with you an example of how to address them and how not to address them and I'm going to give you some tips on what, how you can do them faster without having to spend a lot of time racking your brain like oh my god what does she you want like I just don't get it, tell me what they want. I'm gonna tell you what they want. So first I'm going to share my screen here with you, let me just get that up here. All right so what we can see here now is a, this is one one category as a clinician what would an entry and a practicing nurse be expected to know and be able to do for their patient population? And let's just say we are going to select that we provide safe ethical confident compassionate client centered and evidence-informed nursing across the lifespan in response to client needs. WHOA, that is a mouthful. I'm going to copy this. Copy that because we're going to now go to a whiteboard. Competent compassionate client centered and evidence informed nursing across the lifespan and for their needs. Now here's the evidence I will get, that I do not want you to pu.t I provided safe care for my patient I was compassionate and focused on the patient. Yes I felt confident with my care. So in writing this which by the way is not how to address and I make this in red and do not do this one. This tells me nothing as a reader all you've done is restate the competency. What we're looking for is evidence. Let me say that again what we're looking for is evidence. Okay. So let me start by saying what is the action word here? Can I do a highlight? I don't think I can but I can do a spotlight so here's the key word, provides. Provides is an action word so you need to be showing me what you did. Answer the question: what did I do that was safe? that was ethical? that was competent compassionate client centered and considered the lifespan of the patient population? So I'm going to focus, let's just say working in a geriatric, that's pretty commonplace for a lot of new nurses to work and a lot of students in, a lot of students to go into clinical. Provided action so I cared for a geriatric patient who was diagnosed with dehydration. Let's just do that one. I'll fix that spelling in one second here. Change the color here, oh it's no not blue we already got blue boring. Dehydration. Okay so this is telling me I have a life span, I have a geriatric population, I have a diagnosis which situates my mind set as the reader as to what potentially I might be dealing with okay. I now know a few things but what do I do about that patient? The patient's, okay no wait let's do it this way, while assessing their IV I noted it was not infusing. ahhhh There's a problem After troubleshooting, I determined from my evidence base the IV was interstitial and it was removed. So that's some evidence base to have some critical thinking happen here and this is compassionate. You do not want to leave in that IV if it's interstitial and it is not infusing. Okay. So what else did I do? Okay let's move on. With this I used - what else would you use to help with an IV that's interstitial? A warm compress to help reduce the swelling. Evidence-based informed action okay, it is compassionate at the same time because you do not want them to suffer in pain. Now client-centered absolutely we're focused on the patient. Ethical and safe. Yes and yes. There's no ethical dilemma here I suppose if you had left it in I would have an ethical dilemma about your practice. Okay so we're looking focusing on this part. Let's just up the ante a little bit more and say that the patient was confused and unable to state where they were. This is different than the morning's assessment. I spoke with the daughter who said this is the first time patient has been confuse. Ok so I have another problem here that's potentially related to dehydration. Okay. It may not be. It could be something else. It may be an infection happening or something. We are talking about dehydration and we're going to connect this to dehydration now. I talked to the doctor and received an order for an HDC. For those who don't know HDC hypodermoclysis, I have a video on that as well and so this is addressing the patient's need to still be treated for dehydration so this is competency, collaboration so it's compassionate we're not just ignoring them, we're going to return and come back with an HDC instead of an IV because the HDC can stay in longer and deliver the amount of fluids and we want to make sure that they're not continuing down this negative spiral. This is how you answer a competency. Did I demonstrate that I provided care? Absolutely. Was it safe care? Yes. Was it ethical? Yes I didn't ignore the problem. Competent? Absolutely .Compassionate? Yes. Client centered we could actually add here for compassionate that the patient was reassured that they did not do anything wrong after she stated "I am so sorry dear for causing you this work" Okay. All right. So that's how you answer a competency. Let's do another one. I'm going to get rid of this okay coming back over to my second screen I'm just gonna grab one. I'm gonna pick a different column, I could share that screen with you let's do a new share I'm gonna go down into let's see professional, all right a lot of people pick these they're pretty easy to do they think. Demonstrates accountability, accepts responsibility, seeks assistance necessary for decisions. well let's let's do one of these because they look easy but often people don't give data and that's what I want you to really focus on is data. So let's just pick two point two what does this one say? I know I got a little bit extra there let me just fix that and it's always good to put the number in here I don't think I did that with the last one but just to make sure we do that. 2.2 demonstrates a professional presence and confidence honesty integrity and respect and all interactions. Perfect. Good. Now let's talk about what most people put down. Okay so when caring for my patient I was respectful and professional with my peers. I am going to make that in red cuz I don't like it. No, I'm going to be blunt, this sucks. When you restate the competency you haven't met the competency and that's an important thing to recognize. So let's write this one out. What would this look like? Okay the thing, the verb is demonstrate so again this is another action word so I need to give evidence that I have done something. Not that I've thought about it, not that I can reword it but it actually physically done something. And what is it I'm looking to do? Have a professional presence, confidence, honesty, integrity, and respect at all interactions. Now here's the kicker. You do not have to meet these you can say I didn't meet this in this situation here's what I'm going to do next time. So let's do one of those. Okay let's pick a new patient and a new color. This time we will do blue. Alright so here's the scenario, let's paint the scene so that the reader has an idea what's going on. Carrying for an 11-year old post fractured arm. Sure, okay so I have this patient who's in the hospital after breaking their arm and one day after surgery. There we go a little bit more information. Okay we're gonna do one where I didn't meet the competency but I have an action plan. So let's see: professional appearance, confidence, honesty, integrity and respect. Let's pretend that this is the first time I've had to care for an eleven-year-old who's broken their leg and I was like freaking out myself because I don't know what to do with an eleven-year-old. It's my first day on the job. I made some comments that were not, um, that were not received as favorable. I stated "guess you won't be riding your bike like a maniac again will you" The patient's ah I can't spell, patient's family was upset with me because he child had only just learned how to ride and was proud of his accomplishment. I realized after that this statement held a lot of judgment and provided an opinion on how he should live his life. I was not feeling very confident about how to care for this child and was, and covered it up with a judgement. I recognize now that statements of opinion should be kept to myself and I need to stick to the facts. What I could have said differently: since this happened while riding your bike what will you do differently to prevent this from happening again? This statement would allow the patient to identify reasonable options going forward without feeling pressure to do what the nurse said. I recognize as a nurse I hold nurse I hold a lot of power in a relationship and I need to be mindful. I am honest with myself in this reflection I'm reflecting back on what happened I wasn't quite, I didn't have good integrity in it, I'm recognizing that I need to be better at that and my respect was certainly not there because I was judging so this example gives me evidence of doing, gives me evidence of what you said, what the impact was and what you're going to do better next time. BONUS This is how you deal with competencies guys let's just do one more. I recognize that the typing, hmm, we will just go with that. let's go back we'll just go with that okay let's go back to sharing my other screen cuz I want you to see what I'm picking it's like playing bingo. Let's see where we're going next shall we? Okay communicator let's just randomly pick number I don't know what ICT is so not gonna use that one. Okay conflict resolution speaks to my heart so we're gonna go past cuz I could just talk about that one all day. Let's do collaborator or scholar. Scholar is a bit challenging for some to- why don't we go down to scholar. Even leader is hard for people. Advocate, holy geez, educator there we go scholar; uses evidence to make informed decisions. Let's grab it. Coming back to the whiteboard. Okay we're gonna put the number in there and this is 9.1 Okay, I am going to tell you what to do first. Okay. I used my patients assessment data to tell me, or to advise, to guide my care for the day. it helped me plan my care. Using evidence is important as a nurse because without it we would be lost. Alright you read that right? This is pretty similar to stuff that I get as a teacher like this is no joke people restate it and then they give me some other sentence that makes it sound like they've done something, it says nothing. Okay so let's look at how we can address this one. Uses - action word, best evidence - I need to talk about evidence - to make informed decisions- to show that it helped me make a decision or I missed making a decision and what's my action plan. So I think sometimes the confusion is with the competence that you have to pick one that you've met, that you've done really good and that's not the case, you can even do it partially good so let's do a partially good one here with an action plan. Okay because we always want to be looking at how I can get better. All right uses best evidence to make informed decisions. Last night when working with one staff member absent, so we're short-staffed, I could have said that differently, I recognize that, you get the gist, let's just change the color here. Okay last night we're working with one staff member absent we had only three nurses to care for 32 patients. Ridiculous! I know there's other places to work in worst conditions. With no support available, we needed to devise a plan to ensure patient safety. We decided that only one nurse would take a break at a time and we did not communicate. Well we ended up with two nurses on a break at the same time. One was off the unit and the other has to be called back. So we talked about it but we didn't follow through. and I could do, actually let me get a little bit more information. And they were to happen at let's say we're doing the late shift 2:00 a.m. 3:00 a.m. and 4:00 a.m. and we did that communicate well the first break happened because we ended up with two nurses on break at the same time. That's a lot more information gives me a whole different picture right. So what's the results of this? We ended up, okay the the nurse who was supposed to go on break was the one that was called back because she was on the unit. As a result she did not get time to finish her break and needed to apply for overtime. All right so we're showing that best evidence, um, okay we need to talk about best evidence still. We know that nurses who are tired and fatigued and maybe a little upset are more likely to make errors. This did not happen on our shift but we were at higher risk. There's an impact. We made a decision we did not communicate very well and here's why we made that decision and here's what could have happened. This gives me data okay. Now you can't do these point form, you don't have to make a paragraph, you can certainly do this point form. Let's try that here. Let's see, working short-staffed only three nurses instead of four, let's change this color just so you can see how this can be done. purple no I don't want something darker darker blue breaks determined for two am 3:00 and 4:00 a.m. but two nurses left at 2 a.m. leaving the unit vulnerable. Nurse calls back at 2:15 a.m. did not get her break for the rest of night, was tired and cranky, risk factors for errors. We reviewed our communication plan and found our errors, and found the error, and will write out on the white board next shift. Something to that effect. So you can't do it point form it feels a little bit less of a story a little bit less connection but the information is there. So we were working short-staffed three nurse instead of four, so we came up with a plan, best evidence suggested that we should only have one nurse off at a time, two three and four but when two left at two o'clock were like whoa we're vulnerable best evidence says we need two have to hear who called one back and then she didn't get her break first the night and on top of that we know that these are risk factors for errors and patient harm. So we reviewed our plan and we're gonna fix that for tomorrow night. Let me stop my screen share. So that is how you address competencies. Look at what the action is telling you to do, look at what action you are going to be doing, and then give the evidence, tell me the story right a little scenario so that people can get situated and then connect the dots all the way through. I hope this helps and until next time don't forget to subscribe down below, make sure you get all the videos as they come out, share this with your friends let them know - and make it a great day :) you have that power. See you next time