DRAFT: This module has unpublished changes.

Blog Post Week # 9

 

Introduction/overview of week’s goals and accomplishments

 

During the past two weeks, I personally experienced some unexpected setbacks, but with great support from my partner in the clinical field, I was able to continue progress on my clinical assignment.

 

One of my goals for this week was to complete all in-office assessments by 10/25/18. On 10/25/18, the majority of clients that came into the office were clients that completed our assessments before. However, we were able to accomplish this goal by offering all the clients who participated in the health lectures a chance to participate in our interviews and all accepted. “Flexibility is a common indicator of the ability to accomplish the project’s stated aim” (Harris & Ward-Presson, 2016, p. 104). By being flexible, we were able to find a method to compete our goal of interviewing 15-20 clients by changing our interviewing strategy and location. This increased our number of participants greatly and helped us to achieve our goal to complete in-office assessments.

 

Another goal was to prepare for the health education workshop. We did this by presenting two small health lectures on diabetes. This helped us to understand what was involved in preparing at health presentation at the retirement center and it helped us to address the needs of the community. “Consideration of the audience is critical to an effective presentation” (Dearman, 2016, p. 232). By presenting this workshop, we were able to understand what the principal needs of the community are and how we can tailor our individual presentations to meet the needs of the community. We were also able to gain participants by encouraging them to participate in our interviews and in our health workshops.

 

Finally, my last goal was to prepare for the health education workshop that Napiela and I will be presenting at the clinical site. We spoke to the activities coordinator, Ellen, at our clinical site and were added to the calendar of activities in order to notify all residents and maximize attendance at our workshop. We began looking into the technical equipment to see how we can present using PowerPoint presentations. Personally, I began doing research using the Suicide Prevention Resource Guide. The goal was to assure that our project meets both aspects: explicit and implicit. “The explicit purpose is the stated reason for the presentation; the implicit purpose is what the presenter actually hopes to accomplish” (Dearman, 2016, p. 233).

Utilizing the Suicide Prevention Resource Guide helps a lot with that. They have a lot of online self-paced learning modules which I plan to complete in order to bolster my education in developing my local suicide prevention program to have maximal impact and identifying activities that will be effective in addressing problem of suicide. The website also had many resources including a toolkit on “Promoting Emotional Health and Preventing Suicide in Senior Living Communities”, which will be one of my resources in creating and presenting my health workshop.

 

Challenges (anticipated and unanticipated) faced and strategies used to overcome challenges/barriers

 

There were many barriers that presented this week but overcoming them helped me to appreciate and continue to work hard to complete this project.

 

Primarily, one of my goals for this week was to complete all in-office assessments by 10/25/18.  However, I missed one of my scheduled clinical days due to an unforeseen health circumstance. While at work on the day before clinical, I was injured on the job and could not make it to the clinical site. I was unsure of how I would complete this goal because. Missing a day was devastating to me because I already have so much trouble getting time off from work, so I felt completely set back. However, great communication and collaboration from my clinical partner helped me to still remain on track with project progress. All the clients she screened for falls that day, she also screened them for depression risk, which helped me to remain on track with my statistics and data entry. This helped me to realize how important it is to incorporate agility into my project. “Agility is a concept that encourages flexibility, adaption, and continuous learning as a part of the implementation process” (Roussel, Polancich & Beene, 2016, p. 163). Being flexibility and adaptable helps to take unexpected outcomes and discover how to continue to progress in spite of the unexpected.

 

Secondly, we realized that many of the clients coming into the office were repeat clients, meaning they were patients that we had already interviewed. We wanted to increase participation but were unsure of how to do so. Our preceptor Nurse Alla was extremely helpful in that respect because she encouraged us to interview clients in diverse settings. We conducted a health lecture this week and afterwards, we offered our survey to all of the attendees who had not participated in our interviews before; all accepted.

 

Thirdly, one of our challenges was coordinating and organizing our capstone presentation. The key goals I wanted to implement in the presentation is APPLE, or “audience, presentation, purpose, language, and evidence.” Following this guideline will assure that the project “provides a ready structure that is amenable to any presentation whether one will address a group of students, peers, or an international gathering” (Dearman, 2016, p. 232). . We had initially spoken to the activities coordinator about being added to schedule for November in early October. However, she had already complied the final schedule and sent it to be printed. Thankfully, we spoke to her before printing and she was able to confirm our presentation dates for November 12th and November 26th . Having these dates organized will assure that we will have a clear timeline for our presentation and that the community will be made aware, increasing the number of participants in our health workshops.

 

Utilization of coaching and/or mentoring

 

Nurse Alla continues to be a great support system for us. Firstly, Nurse Alla gave us ideas on how to diversify the ways we can gain participants for our surveys. She encouraged us to offer our surveys to clients post group activities and after the health workshop. This allowed us to encounter people who do not normally come into the office, people we would not have met otherwise.

 

Secondly, since she knows that health workshops are a large part of our clinical project, she allowed us to lead health workshops under her supervision. By leading these health workshops, we were able to have an idea of how health workshops work in this facility and what we would expect when presenting our own health workshops. It also allowed us to see what challenges we may face during our health lectures. Some of these challenges including interruptions and people taking the topic off track, things that we noticed during the diabetes presentation. Our ability to overcome those barriers during the presentation showed us how we can tailor our presentations to meet those challenges. Preparation for the presentation includes appreciate inquiry, which helps to give life to a presentation. Cooperrider & Whitney (2010) explains “AI includes the art and practice of asking questions that strengthen a system’s capacity to apprehend, anticipate, and heighten the positive potential from a project or innovation” (as cited by Dearman, 2016, p. 234). Appreciate inquiry helps to share the hidden aspects of a project that is not readily clear to the audience. It helps to ensure transparency during the presentation process which will help facilitate good team and audience reception.

 

Thirdly, she continues to debrief with us post home visits and post the health lecture to help us see how we can improve. After the health workshop, she asked “What challenges did you face? How did you overcome them? How can you do better the next time?” These questions helped us to reflect on our work and see how we can do better in our independent presentation. “Good communications management requires expending effort on sharing information, which contributes to project success” (Dearman, 2016, p. 158). When we verbalized the challenges that we faced in our health lecture, she gave us practical suggestions of how we can overcome them next time. Opening the lines of communication between our experience preceptor and ourselves helped us to acknowledge the changes we needed to implement and discover methods that ensure that our project becomes a success.

 

Capstone Project Plan Progress

 

Personally, I believe that the project is progressing rapidly again. First, we have completed our in-office surveys. Secondly, I have identified the clients who were high-risk for depression and suicide and began calling to see if we can schedule home visits with the clients. Finally, we have concrete dates for our health workshop, so we can finish preparing our presentation, culminated with the ideas of how to tailor these presentations for the community.

 

Leadership lessons learned

 

One of the major leadership lessons I’ve learned this week is to expect the unexpected. The Jewish holiday as well as my work injury were both instances that could have set back my project progress. However, through great communication and organization, I have been able to overcome these setbacks and continue to make progress in my project.

 

Another leadership lesson I’ve learned is from observing Nurse Alla. A great leader seeks to empower others by helping others to recognize their falls and improve to be better the next time. “ Empowerment of others, clarity in vision, and expectations of transformative change through the leadership of teams generate synergy and creative possibilities not previously considered” (Thomas, 2016, p. 91). As our team leader, she helps think of things that we had not previously considered in order to accomplish our projects in the most effective ways. This, in turn, empowers us as nurses and change agents to view the project through different eyes and make changes to our project that best reflect the needs of this community. Through her debriefing strategies, she embodies qualities of a transformational leader.

 

I think the best leadership lesson I’ve learned is that being a leader means being part of a winning team.  “Managing a successful team that is dedicated to improvement and practice change requires the development of reciprocal trust and continuous interpersonal relationships among team members” (Harris & Ward-Presson, 2016, p. 102). Napiela and I are both leaders and team members in our projects, so we seek to work together and help each other. This helps us to never feel overburdened by our workload and the knowledge that we have one another’s support to complete our work.

 

Outcomes Achieved

 

We have achieved so many things with regards to our capstone project. First, we have completed all of the in-office assessments, effectively completing our initial data collection portion of our project. Secondly, I have created the in-home assessment tool that I will use during the home visits we will be starting this week. Finally, we have the dates for the health workshops, so we can really begin crafting our presentations for the community. With the progress we’ve made, I’m excited to see how the next two weeks will continue as we progress towards completion.

 

Track clinical hours weekly / running total

 

COURSE: NURS 499 weekly log

 

STUDENT

DATE

HOURS

CUMM

NOURS

ACTIVITY in clinical, plan for next week

9/10/18

1

1

Spoke to Evelyn Gottlieb, Director of JASA NORC to identify some safety issues at the facility

Researched information on Baruch Newman Library (CINAHL) about diabetes workshop as per suggestion of Ms. Gottlieb

9/11/18

1

2

Spoke to Professor about clinical instruction and research focus for capstone project

Encouraged to focus on link between diabetes and depression

Researched articles on Baruch Newman Library (CINAHL) concerning risk for depression in diabetic patients

9/17/18

8

10

Visited clinical site

Met preceptor and discussed care and safety needs of community

Identified safety issue: Depression/Isolation in Geriatric Clients

9/19/18

2

12

Researched various Geriatric Depression Screenings

Identified screening tool to be used in office visits(Geriatric Depression Screening-short form)/home visits (Geriatric Depression Screening-long form)

Researched articles on Baruch Newman Library (CINAHL) about depression in the elderly

9/27/18

8

20

Began screening patients in office using geriatric depression screen (GDS scale)

Screened patients at community party for signs of geriatric depression using GDS scale

Compile and analyze initial data-identify clients at risk of depression and collect information to engage in home visits

Observed two home visits with preceptor in order to develop and understand what the home visit process is like and to develop ideas on how to personally conduct home visits

NEXT WEEK: Will continue to screen patients in office for depression/form rapport with repeat visitors to encourage participation in project

COURSE: NURS 499

 

STUDENT

DATE

HOURS

CUMM

NOURS

ACTIVITY

10/01/18

8

28

Continued screening patients in office using geriatric depression screen (GDS scale)

Compile and analyze initial data on Excel table-identify clients at risk of depression and collect information to engage in home visits

 

10/5/18

2

30

Researched articles on Baruch Newman Library (CINAHL) about depression in the elderly

Researched articles concerning loneliness and isolation in retirement communities

Engaged in research about mental health/suicide in the older adult

10/7/18

2

32

Researched CDC, WHO about mental health in the older adult & depression in the elderly

Identified training resources and certifications for preventing suicide in retirement communities as identified on Suicide Prevention Resource Guide

10/11/18

 

8

40

Continued screening patients in office using geriatric depression screen (GDS scale)

Compile and analyze initial data on Excel table-identify clients at risk of depression and collect information to engage in home visits

Observed, participated, and conducted five home visits with preceptor (two independently) in order to develop and understand what the home visit process is like and to develop ideas on how to personally conduct home visits

NEXT WEEK: Will continue to screen patients in office for depression/form rapport with repeat visitors to encourage participation in project/begin making appointments for home visits with high-risk clients & refer list to social services/continue research on depression and suicide in the older adult

 

COURSE: NURS 499

 

STUDENT

DATE

HOURS

CUMM

NOURS

ACTIVITY

10/13/18

2

42

Researched information on Baruch Newman Library on depression and suicide risk in elderly community

Begin online self-paced learning on Suicide Prevention Resource Center in “A Strategic Planning Approach to Suicide Prevention” in order to develop local suicide prevention program to have maximal impact and identify activities that will be effective in addressing problem of suicide

10/15/18

2

44

Researched information on CDC website, Joslin Diabetes Center, and American Diabetes Association to prepare for community presentation on Diabetes

Researched information on Baruch Newman Library on loneliness and isolation in retirement communities

Continued to prepare health education workshop with information from Baruch Newman Library and Suicide Prevention Resource Center

10/25/18

8

52

Completed in-office assessments of clients with the Geriatric Depression screening

Conducted two interactive health lecture workshops on Diabetes

Screened clients post health workshop for depression using the Geriatric Depression screen (short-form)

Compile and analyze initial data on Excel table-identify clients at risk of depression and collect information to engage in home visits

Observed, participated, and two home visits with preceptor in order to continue developing ideas on how to personally conduct home visits

 

10/28/18

 

2

54

Continued online self-paced learning on Suicide Prevention Resource Center website on “A Strategic Planning Approach to Suicide Prevention”

Continued compiling research to create the health workshop presentation using PowerPoint

NEXT WEEK: Begin in-home assessments of clients who triggered high-risk for depression in order to assess history, risk factors, and suicidality risk

 

Total: 40 hours clinical, 14 hours research

 

References

Harris, J. L., Roussel, L., Dearman, C., & Thomas, P. L. (2016). Project planning

       and management: A guide for nurses and interprofessional teams. 

       Burlington, MA: Jones & Bartlett Learning. 

 

 

DRAFT: This module has unpublished changes.