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Ideal setting ("if nurses ruled the world, what might a workplace look like?"):

Educational nurse-run urgent care: this would be an urgent care primarily run by nurses with oversight from a couple NP's or doctors. This urgent care works closely with nursing schools to educate students on patient prioritization in an outpatient and non-emergent environment with highly skilled nurse expertise

Democratic-run nursing unit: promotion of the nurse to leadership roles is based on the approval and vote of their peers. There is no campaign for position, but an election from coworkers. Systems such as audits would be in place to ensure the nurse is on top of their work. I thought of this because I have many coworkers who I believe would be great leaders, but never advocated themselves for the position.

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Nurse-run community clinic for families: This would be a nurse run clinic for low income families in collaboration with an NP or MD. This clinic would provide basic medical care for illness and injuries, preventative screenings, check ups, vaccinations and mental health care to low income families in surrounding school districts.

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Group 4 FINAL DECISION on Ideal Setting: Comprehensive Community Health Clinic

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Group 4 FINAL DECISION on Ideal Setting: Comprehensive Community Health Clinic

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Group 4: Brie, Breanna, Jonathan, Clara.

Our ideal setting would be a community health clinic focusing on comprehensive health & preventative care. The clinic would be run by RN's & APRN's, with oversight from MD's as needed for operation. The clinic would accept patients regardless of insurance status, and would provide services at low or no cost to patients. Our clinic would provide services such as:

Preventive health screenings such as annual physicals & cancer prevention screenings (i.e. PAP smear, mammogram, breast MRI, skin checks, etc.)

Primary & family care services for medication management, disease monitoring, and newborn/infant care.

Vaccinations for patients of all ages, including newborn vaccination series, annual vaccinations (i.e. flu, COVID), updating vaccines as needed, and older adult preventative vaccinations (i.e. shingles, etc.)

Mental health resources such as counseling & therapy services, medication management, support groups & social workers

Physical & occupational therapy providers

Nutritional counseling from nurses and registered dieticians for patients with diabetes, heart or kidney disease, GI diseases, pregnancy, etc.

Food pantry and resources for patients with food insecurity.

Outpatient pharmacy

Laboratory

Imaging Center for x-rays, PET/CT, MRI, US

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Healthcare worker wellness clinic:

This would be a clinic that is geared towards healthcare workers and provides mental health care like therapy, counseling, and peer support, health and fitness classes, classes on injury prevention, burnout prevention, and stress management. Burnout can have major consequences for nurses and their patients; and there has been an increase in nurse burnout and compassion fatigue in recent years. Being able to directly manage and prevent burnout and compassion fatigue would be a great benefit for our profession.

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You are genderating some great ideas.

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The "Ideal setting" I'm thinking is a Comprehensive Preventative Health Center that focuses on preventative health and education. It would have services like therapy, outpatient pharmacy, physical therapy, nutritional counseling, nurse health coaching, diabetes education, prenatal classes, support groups, all in one building. All the outpatient services that people may not be required to go to but would highly benefit from, in one location. This place would be led by nurses with a whole body, preventative approach. Often times nurses know what patients will need outside of medicine/procedures but it is entirely up to them to figure it out, which this center can help. I feel like this would be beneficial to the public, those that get discharged from the hospital or those with chronic conditions. Ideally, this would be covered by insurance as well.

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Comprehensive Cancer Center with provider offices, outpatient pharmacy, dietician and nutritional services, infusion center, radiation center, physical therapy, social workers, spiritual care providers, nurse navigators, imaging center and outpatient lab in one campus or central location. It would also be great to have a "transitions" center (i.e. wigs, prosthetics for mastectomy patients, compression sleeves for lymphedema) in the same building. Nurse-run units for infusion centers and radiation center would see patients following visits to providers. Patients can access support services such as nutritional counseling, spiritual support, and social workers at any time. Nurse navigators would provide resources to patients and families, and act as a bridge between providers and nurse-led units to ensure smooth transitions of patients without delays. Treatment centers would be open Mon-Fri, during the provider office hours, same for lab, pharmacy, PT, & imaging services.

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Keep up the great work

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Keep up the this level of engagment

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Our discussion for Rules of Trust was done primarily via group text.

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Group Members: Brie Gelfer, Breanna Moya, Jonathan Pelayo, & Clara Wai

Assignment/Week

Part 1/ Week 1

Leader: Brie Gelfer

Part 2/Week 7

Leader: Breanna Moya

Part 3/Week 9

Leader: Jonathan Pelayo

Part 4/Week 11

Leader: Clara Wai

Part 5/Week 14

Leader: Brie Gelfer

Final Project/Week 15

Leader: Brie Gelfer

Other: Breanna Moya

Other: Jonathan Pelayo

Other: Clara Wai

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1. Communication for the group will be conducted within the group chat, with responses within 24 hours of initial text.

2. All feedback given for assignments will be constructive in nature, with tips or suggestions for improvement included.

3. All assignments will be turned in at least 12 hours before due date/time. Drafts will be sent to the group at least 24 hours prior to due date/time to allow for peer review & edits to be completed. Members must be notified if submission will not be completed by this deadline.

4. All members will complete the assigned tasks & agreed upon duties and/or responsibilities for each assignment.

5. Group members will communicate & actively participate in the group chat & on Padlet throughout the week when available.

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As a Registered Nurse in the MSN Leadership program, my purpose is to enhance my ability to lead teams, improve patient care, and advocate for the healthcare of my community. My goal is to develop strong leadership and management skills, with the long-term goal of influencing healthcare policies and mentoring future nurse leaders to pursue a higher degree.

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My purpose is to promote the health, safety, and overall well-being of my patients while furthering the science of nursing through evidence-based practice and research. My goals are to improve my leadership skills, encourage growth and learning for nursing students, and further my personal nursing skills and practice.

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What's happening on your Padlet? I don't see anything from any of the group members for Group Project Part #2.

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Mission Statement:

The mission is to bring accessibility, and serve patients of all populations with friendliness, kindness, and respect.

Past Trends:

1. Increase in telehealth to offer virtual care after the pandemic and quarantine. This has helped a lot of patients with accessibility issues, and is great for visits such as education, follow up, medication refills.

2. Use of electronic medical records and sharing with patients. Over the years, the use of electronics has become a standard in healthcare across the board. In the past few years, the records have been made available to patients easily via electronic as well.

3. Expansion of nursing roles. There has been an increase in demand of Nurse Practitioners, CRNAs, and other advanced specialized nurses.

Future trends:

1. Use of AI and robotics. I imagine an increase in use of AI, whether it is with equipment to monitor patients at home, or to interpret data and results more quickly.

2. Increase in home health. For patients to be able to receive medical care in home as opposed to the hospital environment would be very beneficial.

3. Higher education, specialty education. Continuous learning is a given but I believe more opportunities to specialize and further education will arise.

Vision statement

Our clinic will be known for its transformative efforts to provide utmost health and preventative services that is affordable, accessible, and exceptional.

Core Values:

Respect, person-centered, compassion, safety

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Mission statement: to provide comprehensive patient-centered care to all individuals and communities with integrity, compassion, and respect.

Past trends:

1. Shifted away from paternalistic healthcare to patient-centered & patient-partnered approach, with emphasis on patient involvement, education, and choice of care.

2. Shifted from treating disease and illnesses to focus on preventive care, including emphasis on community health and outreach with education for risk reduction and health preservation.

3. Increased use of telehealth services to provide care to a broader population of patients, including rural communities and at-risk patient populations.

Future trends:

1. Increased preventative screenings for cancer, including updated guidelines for lung cancer screenings, skin cancer screenings, colon cancer screenings, and breast cancer screenings.

2. Increased community health education programs and services from healthcare organizations for at-risk communities and populations.

3. Focus on older-adult health and wellness, with emphasis on symptom reduction and disease management through aging.

Vision statement: Our clinic will provide free or low-cost primary and preventative health services to communities and individuals at need with a focus on patient-centered care and community health.

Core values: Integrity, compassion, accessibility, & quality

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My purpose within this MSN program is to learn more about myself as a person, a nurse, and a leader. I believe this program will lead to becoming a more compassionate nurse, an engaging coworker, and broaden my opportunities as a nurse. My goals is to use the skills and knowledge I'm learning in everyday work throughout the program, gain confidence, encourage growth in those around me, and advance my nursing career.

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Comprehensive Community Health Clinic

Mission Statement: To provide accessible, high-quality, and compassionate healthcare services to diverse communities, focusing on prevention, wellness, and education.

Trends in the Past 10 Years:

-Telehealth and telemedicine

-Ongoing shortage of nurses in the united states.

-Growing efforts to diversify the healthcare profession.

Trends in the Next 10 Years:

-Integration of AI technology in the healthcare field.

-Focus on mental health care and wellness.

-Growth in advanced practice nurses.

Draft Vision Statement: To be a provider of accessible and equitable healthcare, creating healthier communities through culturally competent compassionate care and education. We envision a future where every individual has the resources, support, and opportunities to achieve better health and well-being.

Core Values: Patient Centered, Compassion, Accessibility, Health Equity

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Mission Statement – To make care accessible to the entire community we serve through use of holistic approaches, compassion, and diversity.

Over the past 10 years some rising trends include the relevance of telehealth, an increase of nurse burnout leading to a bedside exodus, and a shift to value-based care for individuals.

Over the next 10 years I predict larger healthcare corporations buying out more small hospitals to form bigger corporations, an aging population of boomers which will create a bigger need for nurses, and implementation of more artificial intelligence within healthcare.

Vision Statement – To become a model community organization in the region for health promotion of individuals.

Core Values - Holistic, accessible, all-encompassing, and integrity

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I learned from doing this assessment that groupwork is made significantly smoother with good communication. When we started the semester we made the expectations clear and everyone has been communicative with their parts and work. We all actively participate and take into consideration one another's suggestions. I do not believe there are any needs for improvement as everyone does their work appropriately and we have not had any conflicts.

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While reflecting on our group assignments and completing the evaluation, I learned that I am very lucky to be a part of a group that works well together and is fully on the same page. We started by communicating our expectations at the beginning of the semester and every one of my group members has met those expectations so far. We all listen to each other and feel comfortable sharing our thoughts openly. We all actively participate in the decision making process and look to each other if we have any questions or are in need of advice or further input. I do not believe there are any needs for improvement in our group. We have not had any conflict or disagreements and have been very productive as a group.

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This group evaluation made me realize I have a really great group that works really well together. We have a texting group chat and are always communicating. We share at the beginning of each week what the project part is, what needs to be done, and when it is due. We all do our share of this project timely and I never worry someone will not get it done. We are all vocal in sharing our thoughts and processes. They have exceeded my expectations and I feel so lucky to have been placed in this group. I believe the only improvement is using Padlet more. We are not familiar with this platform but we are all committed to learning with the same goal in mind: Pass this course.

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Where is midterm assessment conversation?

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Where is midterm assessment conversation?

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I don't see anything here....

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Completing this group evaluation reinforced my appreciation for my group members and how well we work together. All the members of my group communicate clearly and effectively, with respect, understanding, and professionalism. Everyone makes a point to update the other members of the group if changes to assignments are needed, or if something comes up that might impact our ability to complete our work in advance. I have zero concerns about my group members completing their work, and trust that everything they contribute will be at the highest level. In addition, we exhibit above average teamwork, and always work together to complete the requirements of our group. I am very appreciative of my group mates, and grateful to be able to work with them this semester.

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With our ideal setting being in a comprehensive community clinic, we may experience conflict between RN and more senior leadership or an MD. We may also see conflict or negotiations between two Registered Nurses. Conflicts may be related to allocation of resources or plan of care.

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We have to do a case study this week. A story between 2 people, with a conflict OR a negotiation within the ideal setting we have set up. Use the story, then answer the question.

NEGOTIATION Qs to answer: What is the real problem? What is the BATNA(Best alt to a negotiated agreement) of each person? Whose is stronger? What are the power issues? What are the other considerations in the case? What should the nurse leader/manager do?

OR

CONFLICT Qs to answer: What is the problem? What are the key issues? What is the perspective of each person in the conflict? What should the nurse leader do? What leadership style would be most appropriate for this situation?

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Case Study Conflict: What is the problem? Key issues? Perspective?

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Case Study Conflict: What is the problem? Key issues? Perspective?

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The conflict in this case study is the difference in approach both health professionals want to take in the patient's care. The RN wants to provide thorough, patient-centered care, while the NP is emphasizing the financial concerns and institutional resource management. The key issue is that one prioritizes patient safety and comprehensive care, while the NP prioritizes the financial sustainability of the institution, even at the potential of poor quality of care for this patient. Each individual has a different perspective on the situation. The RN sees herself as being a patient advocate and ensuring that the patient receives the best possible care by being cautious and following clinical guidelines. The NP is relying on the risk assessment showing a "low risk". The NP wants to ensure good patient outcomes but is also aware of the financial impact that this may cause the organization .

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The problem is between an RN (Patty) and another RN (Sally). Patty noticed that Sally has been frequently eating the designated pantry food for patients that are food insecure. The issues are that the food pantry is designated for patients facing food insecurity/financial burden, the food pantry is highly used by patients in the sense there are not many extra items, and the food inflicts financial cost on the facility. Sally believes even though she is financially stable and has her own food, she is entitled to the food from the facility’s pantry since she works at there. Patty believes Sally is costing the clinic extra money and depriving those in financial distress from obtaining basic human needs. Patty decides to confront Sally and use a calm authoritative style of leadership explaining to Sally that what she is doing feels ethically wrong. The food is designated for patients with food insecurity and also costs the institution to maintain. Patty was polite yet stern in her request for Sally to no longer use the food pantry and could escalate the situation to their nursing advisor if she finds Sally doing it again.

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CASE STUDY CONFLICT reflection and questions

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CASE STUDY CONFLICT reflection and questions

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With our ideal setting being a place for low to no cost care, finances would no doubt, become a barrier and cause conflict amongst the team.

What should the nurse leader do? The nurse leader should first acknowledge both staff. The nurse manager should reflect back on the core values of Accessibility, Patient-Centered, Integrity, and Compassion in handling this conflict. Listen to both the NP's thought process with the diagnosis, as well as the RN's concerns and recommendations. Allowing the space to communicate may lead to a mutual consensus between the RN and NP of what to do and what to recommend the patient.

What leadership style?

Servant leadership would be a good one in this conflict for the nurse manager. The idea of servant leadership is about serving other people, and not personal gain or control. Both the RN and NP have the medical knowledge and can work out what is best for the patient, there is nothing for the manager to gain or win. As a leader, being supportive, empowering, and fostering open communication would best serve this conflict.

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Story Conflict: A 45 year-old female patient presents to the clinic for annual physical exam and women's health screening. The patient has historically had clear PAP smears and physical exams. The patient reports longer, heavier menstrual bleeding with new occasional spotting between periods. The RN Sally suggests to the NP Patty that this patient may need a more comprehensive exam, including cervical biopsies, due to the new symptoms and sporadic bleeding. The NP states the patient is "low-risk" with no history of cervical changes, and further testing would be a financial burden on the institution. The NP declines to order more thorough testing as the patient's insurance will not cover it. The RN decides to escalate the situation to the clinic's Practice Manager/Supervisor.

What is the problem?

The problem in this case study is the difference in approach both health professionals want to take in the patient’s care. RN Sally wants to provide thorough, preventative care while the NP Patty emphasizes financial concerns and institutional resource management. The conflict begins when the NP Patty and RN Sally cannot agree on whether more testing should be done for the patient and each side feels unheard.

What are the key issues?

The key issue is one believes more testing should be done for the patient and the other believes further testing is unnessary as it will only cause financial burden to the organization. A compromise and understanding cannot be reached between RN Sally and NP Patty.

What is the perspective of each person in the conflict?

Each individual has a different perspective on the situation. RN Sally sees herself as a patient advocate, taking preventative measures, and being cautious. NP Patty is relying on risk assessment but is also aware of the financial impact this may cause the organization. The conflict continues as NP Patty feels her diagnosis/decision is not being respected to not run further tests while RN Sally feels unheard or disregarded in the concerns she has expressed.

What should the nurse leader do?

The nurse leader should first acknowledge both staff. The nurse leader should reflect back on the core values of Accessibility, Patient-Centered, Integrity, and Compassion in handling this conflict. Listen to both NP Patty's thought process with the diagnosis, as well as RN Sally's concerns and recommendations. Allowing the space to communicate may lead to a mutual consensus between RN Sally and NP Patty of what to do and how best to continue the patient.

What leadership style would be most appropriate for this situation?

Servant leadership would be a good one in this conflict for the nurse manager. The idea of servant leadership is about serving other people, and not personal gain or control. Both the RN Sally and NP Patty have the medical knowledge and can work out what is best for the patient. The nurse leader should provide a neutral space for this to occur as opposed to taking sides or providing personal opinions. As a leader, being supportive, empowering, and fostering open communication would best serve this conflict.

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Each group member will propose at least 3 things (evidence based!) that your imagined setting will need to make it a HWE, and one that will “attract” nurses (e.g. Magnet-like!)

As a group, select the 3 best (evidence based) approaches or ideas for your setting and post the final summary

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Where are your notes and thoughts for your case study?

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1: (For nurses): We acknowledge the importance of furthering nursing education and career development within our organization. There will be tuition reimbursement for employees striving for higher nursing education that have contributed a year of service or more to our organization.

2: In order to continuously strive for improvement and provide the best quality care, a minimum of 1 evidence-based practice (EBP) quality improvement (QI) project will be done yearly within our organization.

3: Members of hospital leadership will have an open-door policy for employees to make suggestions for improvements within their unit/facility and make rounds when possible (make selves visible to their employees). Change and ideas can come from anyone and we must never grow stagnant.

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1. Create a peer-recognition program similar to a DAISY award for all staff. This will improve morale, retain nurses, and improve job satisfaction if the efforts of nurses are being recognized.

2. Professional development and career advancement pathways. Similar to Jon's suggestion we could offer tuition reimbursements, specialty certification incentives, and leadership training for nurses.

3. There will be open communication between all staff including leadership. This could be done through daily rounding, structured feedback meetings, or daily informal communications. Promoting dialogue between nurses and leaders can lead to better communication without fear or uncertainties.

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Hey guys, I posted my HWE ideas as comments under Brie's post. I thought it would help organize on Padlet but it's not that different in the end. Please include evidence based research for the ideas!! It looks like we can agree Financial Assistance is very important and a definite must as one of our 3 HWEs.

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1. Communication

1. Open communication between leadership and staff regarding changes on the unit, such as implementing new practices or policies, and keeping staff updated on organizational changes (Kester et al., 2021). Provide courses to nursing leaders and new staff preceptors that educate them on the skills required for good, effective communication with staff (Kester et al., 2021). Communicate not only about changes to the unit, but also opportunities for growth throughout the organization, such as free courses for skills or education reimbursement, as well as celebrating important occasions and staff achievements (Kester et al., 2021).

2. Recognition

1. Offer cards for staff to fill out for colleagues to give recognition for a job well done, a helping hand, or a great catch they had at work (Makic, 2024). Hang cards received from patients, colleagues, and community members for recognition in staff areas such as break rooms or announcement boards for staff to see during their shift (Makic, 2024). Awards for special recognitions voted on by peers and colleagues can be presented to staff on a monthly or quarterly basis.

3. Autonomy

1. Magnet organizations are required to focus on increasing nursing autonomy in their organization, which allows nurses to impact and change the policies and practices in their environment (Pursio et al., 2024). Our organization can achieve this by encouraging nursing staff to conduct research or present QI/PI project ideas to leadership in order to change practices throughout the organization.

References

Kester, K., Pena, H., Shuford, C., Hansen, C., Stokes, J., Brooks, K., Bolton, T., Ornell, A., Parker, P., Febre, J., Andrews, K., Flynn, G., Ruiz, R., Evans, T., Kettle, M., Minter, J., & Granger, B. (2021, November). Implementing AACN’s healthy work environment framework in an intensive care unit. American Journal of Critical Care, 30(6). https://doi.org/10.4037/ajcc2021108

Makic, M-B. F. (2024, July). Sustaining healthy work environments: Embracing best evidence to inform practice. Nursing Management, 55(7), 51-54. https://doi.org/10.1097/nmg.0000000000000142

Pursio, K., Kankkunen, P., Mikkonen, S., & Kvist, T. (2024, February 6th). Organizational characteristics of nursing practice environments related to registered nurses’ professional autonomy and job satisfaction in two Finnish Magnet-aspiring hospitals: structural equation modeling study. BMC Nursing, 23(100). https://doi.org/10.1186/s12912-024-01772-9

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Healthy Work Environment - FINAL POSTING

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Healthy Work Environment - FINAL POSTING

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Communication

Our organization will have a focus on clear, open, honest communication between members of the leadership, nursing, and ancillary staff. There will be quarterly “Town Hall” meetings where staff can directly address upper management with any questions or concerns regarding issues they are experiencing in their environment. A monthly newsletter will be sent via email and posted in staff areas with updates on upcoming events, construction, projects, and celebrations. Department huddles will be held on a weekly basis with unit or department-specific updates and to address specific concerns staff may have. Clear communication between leadership and staff is a foundation of healthy work environment and promotes trust, respect, and cooperation (Kester et al., 2021).

Employee recognition

Our organization will recognize staff that go above and beyond when providing care to their patients, supporting their peers, and interacting with their community. Comment cards will be provided to patients, families, and staff members to leave “Shout Outs” for staff members they appreciate. Unit or departmental awards or certificates will be given for actions that exemplify the organization’s mission & vision statements. Employee recognition is a foundation of a healthy work environment, allowing staff to feel seen and appreciated by their employers, colleagues, and patients (Makic, 2024). Staff that feel appreciated and are recognized for their actions report higher levels of workplace satisfaction and are more likely to stay at the organization and contribute at a higher level (Jo & Shin, 2025).

Tuition & Fund Reimbursement

Our organization will offer tuition reimbursement for staff that are seeking a degree in higher education, as well as reimbursement for certification costs and continuing education courses. Full and part-time staff will be eligible to receive tuition reimbursement after one full year of employment, with up to $5,500 a year to be given for full-time staff, and $3,500 a year for part-time. Staff can receive reimbursement for the cost of maintaining certification and continuing education courses for up to $400 per year, regardless of full or part-time employment status. Tuition and fund reimbursement encourages employees to pursue higher education degrees and specialty certification while alleviating concerns relating to costs (Waltz et al., 2020). Magnet accreditation focuses on organizations that provide nursing staff with a program that supports certification and education (Lal, 2024). This program would align our organization with Magnet requirements for a greater percentage of staff with higher education degrees, and a greater percentage that have attained certification (Lal, 2024).

References

Jo, H., & Shin, D. (2025). The impact of recognition, fairness, and leadership on employee outcomes: A large-scale multi-group analysis. PloS one, 20(1), e0312951. https://doi.org/10.1371/journal.pone.0312951

Kester, K., Pena, H., Shuford, C., Hansen, C., Stokes, J., Brooks, K., Bolton, T., Ornell, A., Parker, P., Febre, J., Andrews, K., Flynn, G., Ruiz, R., Evans, T., Kettle, M., Minter, J., & Granger, B. (2021, November). Implementing AACN’s healthy work environment framework in an intensive care unit. American Journal of Critical Care, 30(6). https://doi.org/10.4037/ajcc2021108

Lal, M. (2024). Updated Magnet certification requirements. Journal of Nursing Administration, 54(1), 1-2. https://doi.org/10.1097/NNA.0000000000001367

Makic, M.-B. F. (2024, July). Sustaining healthy work environments: Embracing best evidence to inform practice. Nursing Management, 55(7), 51-54. https://doi.org/10.1097/nmg.0000000000000142

Waltz, L. A., Muñoz, L., Johnson, H. W., & Rodriguez, T. (2020, April). Exploring job satisfaction and workplace engagement in millennial nurses. Journal of Nursing Management, 28(3), 673-681. https://doi.org/10.1111/jonm.12981