Nursing Incivility and Communication Strategies

Nursing Incivility and Communication Strategies Nursing Incivility and Communication Strategies ANSWERS QUESTIONS 1–2 AND QUESTION 3-7 USING PROVIDED RESOURCES ONLY BASED ON THE YOUTUBE VIDEO( MAKE OR BREAK INCIVILITY IN THE WORKPLACE). APA FORMAT. ALL THE ANSWERS NEEDS TO BE FROM A CARDIAC CRITICAL CARE NURSE STANDPOINT OR A CRITICAL CARE STANDPOINT. Nursing Incivility and Communication Strategies 1.Have you ever had experiences with workplace incivility or bullying? How did that impact your ability to maintain professionalism, and how did it impact the safety and quality of care for your patients? (8-10 sentences). 2.What communication strategies do you find most useful in a workplace situation?(8-10 sentences). Walden University Nursing Incivility and Communication Strategies Insert your responses to the given prompts in the table provided. Part 1: Examples of Positive and Negative Communication Watch the video provided, which discusses incivility in the workplace and how this impacts other workers and patients. EpsonStHelierNHS. (2019, September 17). Make or break: Incivility in the workplace ESTH 2019. [Video]. Respond to the following prompts based on the situation presented in the video. 1.Provide two concrete examples of differences in communication styles between the individuals in the videos. (1–2 paragraphs) 2.Explain one possible cause of ineffective interpersonal communication in the video. Explain one possible consequence of the ineffective communication displayed. (2 paragraphs) 3.Explain how social and cultural differences can contribute to communication issues between colleagues. Explain how these same differences can strengthen a workplace. (1–2 paragraphs) 4.Describe two healthy communication strategies that could have been used by individuals in the video to improve the situation. (1–2 paragraphs) Part 2: Application to Professional Practice Respond to the following prompts based on your personal experiences in the workplace. Walden University Nursing Incivility and Communication Strategies 5.Consider the ANA’s “Violence, Incivility, and Bullying” position statement. What can you glean from this resource about preventing incivility and bullying that you could utilize in professional practice? (1 paragraph) 6.Describe a specific situation from your personal experience when ineffective or uncivil communication led to an unsafe or unhealthy situation. Describe how the situation impacted quality of care and patient safety. Recommend at least one strategy that you might employ if a similar situation arose in your current nursing practice. Defend the strategy you have selected. (2 paragraphs) 7.List the references you used to support your responses. Be sure to support your responses with scholarly sources. Nursing Incivility and Communication Strategies ? the_continuing_quest_for_parity__hbcu_nursing_students__perspectives_.pdf moving_on_from_structured_communication_to_collaboration__a_communication_schema_for_interprofessional_teams..pdf workplace_incivility_how_do_you_address_it_.pdf the_elephant_in_the_room__nursing_and_nursing_power_on_an_interprofessional_team.pdf ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS RESEARCH The Continuing Quest for Parity: HBCU Nursing Students’ Perspectives on Nursing and Nursing Education COSTELLIA TALLEY1, PHD, MSN, RN, ACNS-­BC; HENRY TALLEY1, PHD, MSN, MS, CRNA; JANICE COLLINS-­MCNEIL2, PHD, MSN, APRN, CPHN, FNP, BC Author Affiliations: 1College of Nursing, Michigan State University, East Lansing, Michigan; 2 Division of Nursing, Winston-­Salem State University, Winston-­Salem, North Carolina Corresponding Author: Costellia Talley, College of Nursing, 1355 Bogue Street, Rm 247, Michigan State University, East Lansing, MI 48824 ([email protected] [C. Talley]; [email protected] [H. Talley]; [email protected] [J. Collins McNeil]) Reprint from Nursing Education Today December 02, 2016 Copyright © 2016 Elsevier Ltd. doi:10.1016/j.nedt.2016.04.006 ABSTRACT The benefits of a diverse nursing workforce are well-­recognized, yet, the attainment of a sustainable, competent and diverse nursing workforce continues to be a global challenge. In this qualitative study, we describe nursing students’ perceptions on nursing and nursing education at a Historically Black College/University (HBCU). Focus groups were conducted with 16 graduate and undergraduate nursing students. Four themes emerged: communication, lack of resources, support systems and professional socialization. Mentoring and civility were identified as factors important to enhance a diverse workforce. Keywords: Diversity Global Nursing HBCU Nursing Nursing Education Student Perspective Minority n n n n n J Best Pract Health Prof Divers (Fall, 2016), 9(2), 1247–1262. ISSN 2475-­2843 © 2007–2016 Winston-­Salem State University n n 1247 The Continuing Quest for Parity INTRODUCTION 1248 By the year 2035, there will be a worldwide shortage of healthcare workers, totaling 12.9 million (WHO, 2006; WHO, 2013). These findings have enormous implications for nursing, because nurses are front-­line healthcare providers and have a direct impact on shaping the health status of patients, globally (Kulwicki, 2006). Evidence indicates that a well-­trained, diverse nursing workforce improves health care quality, patient outcomes, healthcare access, and decrease health disparities (Institute of Medicine, 2004; Institute of Medicine, 2011; Sullivan Commission, 2004). The globalization of nursing “creates an interconnected workforce that crosses international boundaries, systems, structures, and processes to provide care to and improve the health outcomes of people around the world” (Jones & Sherwood, 2014). To illustrate, 8.1% of the nursing workforce in the United States is internationally educated (U. S. Department of Health and Human Services, Health Resources and Services Administration [USDHHS and HRSA], 2010). By the year 2060, 57% of the United States population will be racial/ ethnic minorities (U.S. Census Bureau, 2012). Likewise, by the year 2020, some London boroughs will have ethnic majority populations, and eventually the entire Greater London area (Bains & Klodawski, 2006; Coleman, 2010). The global demand for nurses is fueled by an aging population and nursing workforce, a shrinking applicant pool, unfavorable work environments, the increasing complexity of health care delivery, and international nurse migration (Ford & Stephenson, 2014; Nichols et al., 2010). As the global demands for nurses increase, it is important that we address nursing workforce issues. According to Nichols et al. (2011) “nursing leaders of today must be prepared for a nursing practice environment inclusive of local, national, and global work issues.” Walden University Nursing Incivility and Communication Strategies For example, 41% of nurses under the age of 50 left nursing for workplace related issues (e.g., stressful work environment, poor management, and burnout) (USDHHS and HRSA, 2010). To improve nursing workforce diversity, we must move beyond just counting numbers to addressing factors that influence not only recruitment, but retention. The purpose of this study is to describe nursing students’ perceptions on nursing and nursing education at a Historically Black College and University (HBCU). We define perception as “the process of making meaning about others based on one’s own subjective social and cultural perspectives” (Warren, 2015). HBCUs fit within the “changing landscape of higher education because of the diversification of their student population in terms of race/ethnicity” (Gasman, 2013). Their perceptions can provide insight to better understand employment, integration, and assimilation of a global nursing workforce. Vol. 9, No. 2, Fall 2016 Journal of Best Practices in Health Professions Diversity: Research, Education, and Policy LITERATURE REVIEW HBCUs are institutions established prior to 1964 for the main mission of educating African Americans. Since that time, the enrollment rate of White nursing students at HBCUs has increased to 31% (National League for Nursing, 2009). Students that attend HBCUs are generally from a wide range of cultural and socioeconomic backgrounds and are often low income, first generation, and Pell Grant eligible (71%) (Gasman & Conrad, 2013). The HBCU in this study, is a North Carolina public, master’s level coeducational (a constituent institution of the University of North Carolina) university with a diverse student enrollment (72% African American; 17% white; 2% Hispanic; 9% other; Undergraduate and Graduate; Fall 2012). Although initiatives to increase nursing workforce diversity have been implemented, the numbers continue to be low. For example, African Americans account for 6% of the U.S. registered nurse (RN) workforce (American Association of Colleges of Nursing, 2015), despite being 13.2% of the population (U.S. Census Bureau, 2014). Similarly, Latinos constitute 15.5% of U.S. population, but 5.4% of RNs (Institute of Medicine, 2015). The limited increase of underrepresented nurses has been attributed to attrition, limited pipeline, and limited opportunities for advancement (Xue & Brewer, 2014). The cause of disparities in the healthcare workforce is complex, but includes: lack of supportive environments, racism and discrimination, stereotyping (Hall & Closson, 2005), alienation and loneliness, financial difficulties (Moyce et al., 2016; Wheeler et al., 2013) and the lack of diversity among nursing faculty. Among baccalaureate and graduate level nursing faculty, 7.1% are African American and 2.3% are Latino. This study explored HBCU nursing students’ perception of nursing and nursing education. METHODOLOGY Homogenous focus groups with undergraduate and graduate nursing students were used to explore their perceptions about nursing and nursing education; facilitated by an African American moderator (HT) and note-­taker (CT), who have experience in qualitative research methodology. Homogenous groups allow for cultural and language concordance, and maximizes the groups’ cohesiveness and openness when discussing sensitive issues (Greenwood et al., 2014). Eligible were students enrolled in a pre-­nursing or nursing program, 18 years of age or older, able to speak and write English and willing to participate. Procedures With Institutional Review Board approval, a purposive sample of 16 participants was recruited via email, word of mouth, with the assistance of a faculty member from the HBCU. Vol. 9, No. 2, Fall 2016 1249 The Continuing Quest for Parity Authors used semi-­structured topic guides to generate discussion about the students’ perceptions of nursing and nursing education. Participants completed a short demographic questionnaire. Sessions were digitally recorded approximately 120 min. Walden University Nursing Incivility and Communication Strategies The note-­taker noted nonverbal actions (e.g., crying, head nodding) that could not be recorded. Data Analysis Analysis was focused on students’ perception of nursing and nursing education. Recordings were transcribed verbatim and the coding team independently analyzed each transcript and assigned codes to words, phrases, and sentences. Independently generated themes were reviewed and a final coding scheme was adopted. RESULTS 1250 A total of 16 students (undergraduate = 11; graduate = 5) participated in the sessions; most were female (12), African American (14), and not married (10), ranging in age from 22 to 40 years. Five were first generation college students and 2 were first generation high-­school graduates. Four major themes emerged; two were categorized as barriers to nursing and nursing education: communication and lack of resources. Two were deemed to be reflective of facilitators of nursing and nursing education; support systems and professional socialization. Communication The focus group process enabled students to identify and make sense of shared perceptions; for some, the groups were emotional. One student remarked: I don’t know why I’m crying so much. I think it’s the questions that were being asked and just the ability to analyze some of the things. Hopelessness: Students reported hopelessness in terms of requirements for entry into advanced nursing program and that they would not be able to meet their personal goals. One student made the following statement about a presentation from a major university about their advanced practice program: He didn’t even give us a ray of hope and he didn’t show us any way to move on. I went home that day so depressed, it’s not possible. Everyone was hopeless. Vol. 9, No. 2, Fall 2016 Journal of Best Practices in Health Professions Diversity: Research, Education, and Policy Students also felt that the majority colleges/universities believe that HBCU’s programs were not as rigorous as their institutions. Students reported a perception of exclusion or “weeded out” (slang for eliminate, get rid of). As one student explained: I also feel like I’ve been kind of ‘weeded out’ because I am an African American student coming from an HBCU. Discouragement: Some felt that majority universities do not commit to diversity because of the limited number of minority students they admit. One student stated: and if they do reach out to the minorities it’s one or two minorities and that’s all that’s in the program, and we’re done with that. Discouragement from colleagues, clergy, and management was also reported affecting participants’ differently. One student said: I was the one who, individuals would tell, I wasn’t good enough to go and pursue a master’s degree; I was the same undergraduate student who thought I could never get into ICU and I actually went into ICU as an undergrad. Workplace violence: Graduate students reported lateral and vertical violence from co-­ workers and supervisors; defined as “repeated, offensive, abusive, intimidating, or insulting behavior, abuse of power, or unfair sanctions that makes recipients upset and feel humiliated, vulnerable, or threatened, creating stress and undermining their self-­confidence” (Vessey et al., 2010). Studies report bullying rates of 31% for nurses in the U. S. (Simons, 2008); 44% in Britain (Quine, 2001); and 57% in Australia (Curtis et al., 2007). Workforce violence between peers is termed lateral violence; between different power levels, vertical violence (Waschgler et al., 2013). One student recounted her experience with a nurse manager: they’ve been beat down so much and told so much based on evaluations from other nurses or management that they’re incompetent. And so after a while when you tell me that over a period of time I begin to believe what you say. Well I didn’t believe it, just to let you know (Vertical violence). Discrimination: Students experienced and viewed racism and discrimination as synonymous; especially in terms of opportunities, promotion, and professional development. One student stated: Vol. 9, No. 2, Fall 2016 1251 The Continuing Quest for Parity When I first came onto the healthcare scene, as an African American male, I was treated different than my Caucasian counterparts. I was passed up on different opportunities . . . Sometimes blatantly, sometimes it subliminal, but it’s definitely there. Another student felt that there were barriers in place to limit career progression. I myself have been a Certified Nursing Assistant for ten years. Everything was smooth but the minute I set out to raise up my educational level is when all these obstacles started taking place. . . . so I go back and get my BSN . . . you got your education and you know you’re qualified; okay, why do you have this two year Associate Degree Nurse being a manager and here I am with a BSN degree, you know it’s racism so they put limits on these jobs then you can’t do nothing, so that’s why I’m here now getting my master’s degree. So what else can you say, that, no, you can’t have this position when I have the education and the experience for these positions. 1252 Another student commented on his experience of discrimination toward African Americans. I have not personally experienced it but again, I?ve seen my friends who were African American become singled out because of their color. I do understand that there is a certain amount of racism, culturalism that goes on in the profession and I understand that there’s a difference, I just don’t really know how to address it other than not participate in those type of activities and hopefully my actions will speak loud enough for themselves(statement made by a White student). A Black African nursing student felt that she had to work twice as hard for recognition and inclusion. Lack of recognition and inclusion often lead to isolation and withdrawal from engagement in practice (Likupe, 2015). The Black African nurse provided this insight: I realize that a lot of times there’s so much segregation in class and it’s not just me; people from my country or from my culture all over, not just in this school but in every other school so far agrees. All they say is this, even the African Americans do it to us because we have a different accent, probably do it unconsciously. But somehow we feel left out. I literally have to run after most of my classmates to make sure that I’m included, and after a while you say, you know what, I’m done with this. Vol. 9, No. 2, Fall 2016 Journal of Best Practices in Health Professions Diversity: Research, Education, and Policy Resources Most students were nontraditional, which means that they met one of the following characteristics: older age (? 25 years), delayed college enrollment, financially independent, work full time, attend college part time, has dependents other than a spouse, and/or is a single parent (Pelletier, 2010). Most students received a federal loan (12) to assist with tuition yet still felt that the cost of an advanced degree was almost an unmanageable burden. One student explained: I don’t want to be in debt for the rest of my life but I do want to further my education, so that’s one of my limitations. Informational resources: While students were aware of the advanced practice roles in nursing, insufficient knowledge about the academic process and programs were revealed. I think that if we have information about schools being offered to us, what we can do to perhaps go down that path, and also to speak with somebody who’s currently in the field who can just say to you, hey, this is how it is, this is what I’ve done, this is what needs to be done, someone that you can relate to kind of give you that inner perspective. Lack of minorities: Students related that diversity in the profession and having minorities that “looked like” them makes a difference in their decision to pursue an advanced degree. One student stated that: I think it’s really, really important that you see somebody from your background in the profession that you want to be in or aspire to be in. And so it’s really important that you seek somebody of your color to kind of bridge that gap. Walden University Nursing Incivility and Communication Strategies and: you learn so much about people when there’s a good mix of people. Facilitators In addition to barriers, students suggested facilitators to help individuals from underrepresented minority groups and underserved students seek advanced degrees. Vol. 9, No. 2, Fall 2016 1253 The Continuing Quest for Parity Support Systems Participants identified support systems as important facilitators of their education. Support systems included family, peers, and faculty; stating that these systems are important because they provide encouragement, emotional and moral support. One student stated: I don’t know where I would be if I didn’t have the encouragement from my close knit study group and the faculty and my family. Family support was identified as an essential component for completion or the decision to pursue an advanced degree. A student talked about the sacrifices that family had made for him to pursue a nursing degree: I don’t see how anybody does it without family support . . . I know I couldn’t be where I’m at today if I didn’t have my mother to support me, and say, just try your best. I think that’s a big determinate for me pursuing a higher education, my family’s support (graduate student). 1254 Faculty provided encouragement, situation-­appropriate information, and personal relationships; saying, faculty members encouraged them to pursue advanced degrees on the first day of the nursing program. For some, particularly first generation college students, faculty was a tremendous source of support. A student said: I’m . . . the only person in my family who’s ever graduated high school as well as college so I think the support of faculty plays a role because to have a faculty that believes in you makes a difference. So that’s your support system, your faculty. Another student described faculty as the enablers of a dream. Most of us are still young . . . when you’re trying to figure out where it is your next step is going to land, you always turn to those people that meant the most to you, which is, in my opinion, the faculty. They’re your enablers to accomplish those dreams and without them, we wouldn’t be right here (first generation student). Students spoke about the importance of peers in terms of study groups and having someone that is going through the same thing that they are going through. A student stated that: Vol. 9, No. 2, Fall 2016 Journal of Best Practices in Health Professions Diversity: Research, Education, and Policy for me, personally just to have the friends there to encourage you when you want to quit . . . Another stated: My nursing friends have become like family to me and they’re really there for me. They have my back and I have theirs and we study together, we fight, we make up, but we’re like family and it’s made a difference in making it this far. Students identified the need for professional socialization in terms of mentors and role models by individuals that are currently in the field. Professional Socialization Students spoke of the need to be mentored by students currently in graduate nursing programs, by individuals that are currently in the advanced practice roles that they wish to pursue, and by someone from their racial/ethnic background. For some, mentors and role models were used interchangeably with key components being: respect, trust, and appreciation of each other (Eller et al., 2014). A student made the following statement, in terms of having graduate level students as mentor/role models: I have had the opportunity to work with graduate level students and they have really inspired me as far as going to grad school. Because I look up to them as my big sisters and they give me advise on what to take and what not to take and they have really reached out to me. Another student made the following statement about having someone in the profession as a mentor/role model: As an African American male nursing student, we are limited with resources and role models are a great part of some of our lives, especially someone of tha … Walden University Nursing Incivility and Communication Strategies Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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