Nursing Paper - Managing Multiple Patients

How do you prepare to manage multiple patients?

As any nurse or student of nursing understands, the success of the nursing field as well as the overarching medical field hinges upon the ability to successfully manage and care for the health and well-being of a multitude of patients at the same time. On any given day in any given healthcare setting, a nurse will oversee and care for a differentiated set of patients, all of whom bring their respective medical needs, histories, allergies, procedures, lifestyles, etc. to the table. As such, in able to adequately care for these patients, it is imperative that a nurse be able to organize, prioritize and communicate in order to make sure that patients are properly cared for, error is kept low, and major mistakes are not made.

In many ways, I have found that the ability to multitask and care for multiple patients in the nursing field requires a careful balance of internal organizational skills as well as a knowledge of external aids in the field (i.e. technological applications). For instance, a nurse can be the most organized individual on the planet when it comes to setting an agenda for himself or herself regarding patients on an internal planned level. However, if that same nurse doesn't understand how to use electronic medical records (EMRs) or other facility-wide utilized technology properly, the overall effect of his or her personal organization skills is lost. In this capacity, communication is absolutely key in order to properly manage multiple patients.

While this may seem like an extremely vague technique when it comes to success - telling someone simply, "Communicate!" - it is a simplistic technique that is so often overlooked. Nurses and healthcare professionals have undergone rigorous educational, on-site training, rotations, internships, fellowships, etc. in order to hone their craft, and because of this, many nurses really do know much of what they need to in order to succeed. In this capacity, it may be difficult for some nurses to communicate openly if they are having issues with handling their patients' needs. It is in situations like this that I have seen that fostering a community of open and judgment-free communication is essential in order to manage multiple patients successfully. In realizing that there is no shame in asking and communicating with those around you, nurses are better capable of organizing, prioritizing and thus communicating at a level that will benefit himself or herself as well as the community of patients to whom the utmost care is promised.

What leadership skills are most important?

In the realm of nursing, it is absolutely necessary to set leadership goals for oneself in order to ensure that knowledge, education, and communication standards, as well as standards of operating, are held to the highest level for all nurses as well as clinical educators who come in contact with patients on a daily basis. As such, the use of certain "SMART" goals within the nursing field allows individuals to set forth tasks for themselves which are: specific; measurable; attainable; realistic; and time-bound (AONE, 2014, 1). As any individual working in the medical field - and more specifically in the field of nursing - understands, patient care is evolutionary, subjective, and constrained in terms of time and applicable tasks. As such, for a nurse to evolve in the field, it is essential that the goals that he or she sets be overarching, with the ability to apply to many different medical and administrative scenarios. As such, I believe that the leadership skills of leadership development and organizational planning are absolutely essential in order to become an efficient role model for those with whom I work on a regular basis as well as a nurse who adheres to an understanding that the nursing field is "evolutionary, fluid and dynamic," and requires continued education and leadership training as suggested by and dictated to nurses by the American Board of Nursing Specialties as well as the Accreditation Board for Specialty Nursing Certification.

In working to achieve my leadership development goals, it is essential that a facility's nursing staff be on board in terms of accepting the need for continuing leadership training. For instance, while a successful nurse has obviously shown himself or herself to be an effective leader in order to achieve his or her position, it must be remembered that just like medical techniques and new procedures and drug use, new leadership tactics are emerging every day - and education in this area is just as important as in the others.

The American Organization of Nurse Executives (AONE) Website is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation, and thus holds an enormous amount of information regarding growth as a nurse, including aspects devoted to the SMART goal of leadership development. In searching the site's database for "leadership development," many articles pop up including one entitled: "A comparison of leadership development interventions: effects on nurse and patient outcomes," which details the objective of how leadership development strategies can better patient outcomes as well as nursing actions and relationships within an organization (AONE, 2014, 1-5).

What health care team members can you delegate to?

In the realm of nursing, delegation of tasks is an area of the job that is consistently referred to as a "slippery slope." As mentioned previously, the position of nurse means that an individual will have to manage the care and well-being of a large group of individual patients, and with this group of patients comes the need for a seemingly endless list of tasks to be carried out. And, regardless of the skills and success rates of any nurse, it simply remains impossible for one person to realistically handle all of the tasks that go with caring for a patient. In this area, successful delegation is key, and again, communication comes into play above all else.

Nurses obviously have the ability to delegate tasks to other nurses. This is the nature of a job in which many facilities are short-staffed and shift changes are a common facet of day-to-day success. However, when dealing with how and when to delegate to individuals who are not nurses - for instance to any unlicensed assistive personnel (UAP) - delegation becomes more tricky. Siela, Twibell and Anderson (2006) note that "delegation errors are a primary factor in malpractice lawsuits against nurses, and many nurses are confused about when and how to delegate, and some aren't clear on state laws and facility policies that pertain to delegation" (1).

As such, there is no concrete answer as to who a nurse can delegate to in every situation to protect himself or herself from error and an unintended malpractice suit. The guidelines as to who a nurse can delegate to are thus created by a given hospital or healthcare facility. There are, however, questions that a nurse can ask himself or herself to weigh the decision to delegate a task and have that task be done effectively. Much research appears to note that there are generally six different criteria that must be met in order for a nurse to successfully delegate a task, all of which have become well-known in viewing scores of nursing textbooks, guidelines, websites for nursing, etc. These criteria are: (1.) the delegated task is the right task; (2.) the task is delegated to the right person; (3.) the task is delegated at the right time; (4.) the task is delegated with the right information; (5.) the task is delegated with the right supervision; and (6.) the task is delegated with the right follow-up.

What techniques will you use to organize your information?

As touched upon in my responses to the previous questions, I truly believe that the use of leadership development as well as a focus on technology are absolutely key techniques for successfully organizing information within the nursing field as well as to operate successfully with colleagues, patients and stakeholders. Many scholars in the nursing field have sought to understand how leadership development can be attained in an overarching manner for the entirety of a hospital or organization's nursing staff. For instance, Swearington's 2009 article: "A journey to leadership: designing a nursing leadership development program," notes that nursing leadership development is perhaps the most important aspect of the field in terms of today's consistently-changing health care climate (107). This type of development allows for a better handle on the organization of information, as it seeks to increase the overall knowledge, communication skills, and leadership standards of the organization's nursing staff. For instance, the aforementioned article notes the need for: "an internal nursing leadership development program" based on building leadership, designing methodology for proposed improvements; and allowing nurses to teach each other, thus fostering an overarching leadership environment which is essential for the organization of information.

Additionally, in terms of techniques for organization that are more technology-based, it is crucial that nurses are taught the proper techniques for technology use in order for them to best serve their patients. For instance, Cope, Nelson and Patterson note:

"Being informed consumers and users of technology in health care means that nurses be involved in the selection of new equipment, receive the proper training for its use, and monitor equipment safety and the effect of technology on patients and families on an ongoing basis. Selecting the wrong equipment and technology can be costly and expose the patient to errors. Even when optional equipment/technology is selected, if it is not well integrated into the current delivery system, or it is implemented in a chaotic way, this can result in unexpected costs and increased error" (1).

Such an understanding is again where a nurse sees the need for communication, continued education and steadfast leadership in order to succeed in his or her respective job.