Professional Presence and Influence Homework

Professional Presence and Influence Homework

Professional Presence and Influence Homework

Healthcare has evolved over time, and so has nursing practice.  Nursing knowledge, professional presence, self-awareness are tools that are important when interacting with patients and colleagues.  In today’s era, we are invited to become aware, each moment, of our inner and outer experiences, of our thoughts and assumptions, and their impact on our world (Koerner, J.G. 2011).

Professional Presence

Models of Health and Healing

Era 1, also known as “mechanical medicine” began in the 1860’s.  This was a time when medical practice focused mainly on the physical function of the body.  The mind was not the focus but instead what was  “mechanically” wrong with the body was to be treated, therefore doctors will treat that problem.  For example, a patient with an infection would be treated with antibiotics. During this period, the prevailing assumption was that health and illness were completely physical in nature (Koerner, J. G. 2011).  Era III of medicine, used in present time, continues to evolve and build on the past two eras.  The physical, mind-body focus and non-local medical practice are used to promote healing.  In this rich multidimensional world, we can choose to treat the “whole person,” which includes the physical, emotional, men-tal, and spiritual aspects of our life, by inviting in the power of soul (Koerner, J. G. 2011). 

Models and Professional Presence

Throughout the years, we have seen incredible enhancements in medicine.  In Era I, during the 1860’s, addresses only the physical aspect of health and illness.  In today’s world, Era III, has become very integrated and dynamic in promoting health and treating illnesses.  As we come to understand the beautiful and dynamic body as a quantum entity, a nested hierarchy of varying levels of energy and consciousness, a new way of engaging with illness emerges (Koerner, J. G. 2011).  Era III model of medicine continues to evolve and plays a very important part in my role as a Nurse.   Advancements in medicine such as: stem cell research, HIV cocktails, cancer therapies, high technique surgeries, and vaccinations are part of current day, Era III model.  Yoga, therapeutic breathing, meditation are also included in the Era III model.  As an Oncology Nurse, I have witnessed the therapies, high tech treatment that the patient receives as part of the healing experience. 

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Patients on my unit go through chemotherapy, radiation, and multiple drug regimens that present incredible results.  Part of the treatment plan include volunteers that come in to play music with their instruments to provide music therapy, and the Chaplin who come in to pray with patients to provide spiritual healing.  This multi-dimensional approach help promote healing to the physical, emotional, mental and spiritual aspects of the patients life as a whole.  Nurses on my unit including myself often sit with patients at bedside to interact one on one.  This short, but therapeutic interaction helps build a strong nurse-patient relationship.  Patients often reveal their feelings, thoughts, and emotions. The simple conversation may be about sports, food, or the weather, but in the end patients feel safe, comfortable in the care of the nurse.

Influence on Nursing Practice

Growing up in Queens, New York, in the most diverse population of the world, helped me to become a culturally competent nurse. As an Oncology Nurse in New York City, patients that come to be treated are from different backgrounds, culture, and ethnicities.  Therefore professional presence and mindfulness of one’s cultural, spiritual and emotional needs is very important.  Recently, there was a patient of mine, who was in her 50’s, Muslim, from Bangladesh, undergoing treatment for Acute Lymphocytic Leukemia with Chemotherapy.  She was placed in a double-bedded room.  A few things came to mind upon receiving this patient.  Privacy was a concern for both this patient and her neighbor.  Bengali’s are very family oriented, and family visits very often.  Patient is a Muslim woman who prays 5 times a day.  Diet is a concern because often loss of appetite is common in cancer patients and she was accustomed to Bengali food.  The Team’s focus was solely on her physical needs (Chemotherapy).  To treat this patient as a whole, her physical, emotional, mental and spiritual needs must be met.  Talking and actively listening to the patient helped me develop and implement a plan including the multidisciplinary team to meet the patient’s needs.  Patient was able to transfer into a single bedded room to maintain privacy during prayer, and accommodate family members that visit frequently.  Patient never ate meals provided by the hospital but now was able to have family bring her food and store it in the refrigerator in the room. 

Personality Assessment Submission

Test Results Analysis

The Keirsey Temperament Personality Test is a self-assessment of one’s personality.  It is based on questions, which at the end will determine your temperament.  It is a way to learn and understand self and others.  The four temperaments include Artisan, Guardians, Idealist, and Rationals.  Guardians are logistical.   They are organized, practical, value security/stability, loyal, hardworking, uphold and follow rules.  Artisans are tactical.  They enjoy freedom and artistic expression.  Idealists are diplomatic.  They have strong values, want to be needed, and live a meaningful life.  Rationalists are strategic.  They are calm, curious, innovative, and pragmatic.

Preferences Alignment

The test results from The Keirsey Temperament Personality Test revealed that my temperament type is a Guardian.  Supervisor, Inspector, Providers and Protectors are the four types of a Guardian.  Guardians are the cornerstones of society, for they are the temperament given to serving and preserving our most important social institutions (Keirsey, n.d).  My personality traits closely align with traits of a Guardian.  Guardians make up 45% of the world’s population.  When it comes to relationships, they value trust and loyalty.  As a Guardian, I am straightforward, reliable, honest, loyal, and I expect that from people around me. 

At work co-workers, and upper management view me as a very reliable person who focuses on getting the job done and often come to me for assistance with important tasks.  A Guardian likes to follow rules, and want to know what is the right thing to do.  Like a Guardian, I am a “by the book” person.  Nurses are often faced with ethical dilemmas when caring for a patient.  When I am faced with an ethical dilemma at work, I always follow the rules and do what is right.  For example, patient’s family often ask Nurses and Doctors to withhold certain information from the patient to prevent emotional distress.  The right thing to do is to disclose all information regarding the patient’s health to the patient because they have the right to know. 

Guardians are very family oriented.  They organize time well to balance work and family life.  Like a Guardian, family customs, and tradition is very important to me.  Every year, my family and I always get together for dinner on Christmas Eve, and attend Church together on Christmas day.  This has been a tradition for many years.  Guardians tend to be very involved in community events, and often times participate in those events as a family.  A recent community activity that my family and I were involved in was a neighborhood car wash to raise money for charity.   When it comes to careers, Guardians value job security.  They often select careers that don’t require relocating.  The reason I chose nursing as a career was because of job security.  I knew that people get old, people get sick, and therefore nurses are always needed.  I currently work at a very reputable hospital in New York City, under a union with great benefits.  I feel very secure with my job at this point, and plan on growing with this organization. Guardians are very conventional and want to do what is right instead of doing what makes them happy.  I feel that this relates to me when it comes to my career.  I have always wanted to move to California because I enjoy warm weather, and a very slow paced lifestyle, which is opposite to living in New York City.  But, because of job security I feel that the right thing to do is to stay.

Potential Challenges or Barriers

There are many potential challenges and barriers when working with an artisan personality type.  A person with an artisan personality trait lives life in the moment.  They often improvise, and figure things out as they go.  They are very tactical, and have “physical intelligence”.  A person of artisan personality would probably pursue a career as an actor/actress, musician, mechanic or an athlete.  In nursing practice, a potential challenge when working with an artisan personality type is the quality of work, and meeting deadlines.  Artisans want work to be done quickly in a short period of time. 

They are hands on, like to improvise, and learn as they go.  As a Guardian, I am a concrete thinker, and a “by the book” person.  For example, there is a new Nurse whom I work with who very often improvises and creates new ways in getting things done quicker.  This compromises the quality of work.  This affects me, and the unit because we all work as a team.  As a guardian, it is very challenging to work with this person because when it comes to patient care there are policies and procedures that are in place specific to the care that is provided.  Self-awareness, and recognizing the personality trait of the individual helps improve the relationship with this person.  

As a senior nurse, approaching this person, being straightforward, without being confrontational, and providing input can help overcome these challenges and barriers.  Meeting deadlines can be a potential challenge when dealing with a Nurse Manager with an artisan personality.  A manager with an artisan personality expects work to be done quickly. As a guardian, who follows the rules, respects authority, to satisfy the manager’s expectation I would rush tasks that need to be completed, compromising the quality of work.  This gives me an uncomfortable feeling but being self aware, and recognizing my manager’s personality trait helps me mentally prepare myself.

Whole Person Goals/Achievement of Goals

Physical

My physical goal is to improve stamina and eat healthier.  I would like to improve my stamina so that I can be able to complete in the annual Empire State Building Run-Up.  The building is 86 floors, and consists of 1576 stairs.  Lately I have been eating out often due to a busy schedule.  By eating healthy I would like to lose ten pounds within 2 months.  To complete The Empire State Building Run-Up I would need to improve my stamina drastically.  I will train three times a week.  Exercises will consist of 30 minutes of jogging on a treadmill, 30 minutes on the stair climber, and one hour of weight lifting.  Sticking to a strict diet will help me lose ten pounds in two months.  Counting macronutrients will help me count the calories that I am allowed to take per day, and manage the amount of protein, fats, and carbs that I eat.  By not eating out, and buying groceries, and meal prepping will help with the diet.  Exercising routinely, losing weight, and achieving my goals will help improve my cardiovascular health. 

Vital/rhythmic

Nursing is a very stressful profession.   Many hours are spent at work and sometimes we consider work to be our second home.  Nurses are often sleep deprived, and always tired.  Organizing time, balancing life at home, and life at work is important to ones health.  My goal is to have 8 hours of sleep per day, and practice daily breathing exercises for relaxation.  Sleeping 8 hours a day is attainable even for my busy schedule.  Cutting back on time spent on social media will allow me to make time for extra hours of sleep.  A healthy circadian rhythm can help improve overall health.  Breathing exercises help with anxiety, and improve energy.  Since breathing is something we can control and regulate, it is a useful tool for achieving a relaxed and clear state of mind (Weil, 2017).       

 Spiritual

We often forget this aspect of life because we are so busy with work. As a man of Catholic faith, my spiritual goals are to pray daily, and attend mass every Sunday.   My family will support me in attaining these goals and will accompany me in attending every Sunday mass.  I will hang a rosary on the head of my bed, which will serve as a reminder to pray before going to bed.  Spiritual healing is important to ones health.  Working to achieve these goals will bring spiritual healing, and promote health in the “whole person”.      

Emotional/Mental

The prevalence of mental health disorders is rising.  Anxiety and depression are common mental disorders we often deal with.  We live in a fast paced world where technology controls our daily life and sometimes we forget to slow down.   My goals to improve mental health are to spend 2 hours out of the week to myself, and to keep a journal.  Time to myself is important because it gives me time to reflect.  In the 2 hours I have to myself I will walk in my favorite park, or watch a movie.  Keeping a journal and writing down thoughts, feelings are a good way to release stress.  I recently downloaded a Journal app on my iPhone and set alarm clock reminders every night to remind me to write in it.

Best Practices

The Samueli Institute coined the term Optimal Healing Environment (OHE) in 2004 to describe a healthcare system that is designed to stimulate and support the inherent healing capacity of patients, families, and their care providers (Sakallaris, Macallister, Voss, Smith, & Jonas, 2015).  Optimal Healing Environment includes the internal, interpersonal, behavioral, and external environments.  The two health care facilities that use this framework of healing are Montefiore Hospital and Grinnell Regional Medical Center.

            Montefiore Hospital has incorporated the Optimal Healing Environment focusing on enhancing healing through their services.  Montefiore focuses on improving privacy, air cleanliness, lighting, sound control and reducing environmental stressors.  Nurses at this hospital initiated Silent Hospital Help Healing, a program designed to focus on control noise levels at the hospital.  Summer Concert Series at Montefiore Hospital are concerts that are held weekly where patients, guests, and employees can all get together to connect and interact.  Creative Arts Therapy program at the hospital is used to promote social boding, and reduce stress and anxiety.  Montefiore Hospital building is designed to allow exposure to nature.  The hospital includes interior and exterior gardens, and aquariums with a nature theme.  Studies show that well-designed hospital environments can reduce patients’ anxiety and stress, accelerate recovery, shorten hospitalizations, reduce medication use, lessen pain, and promote a sense of well-being (Creating a Healing Hospital Environment, n.d.). 

 Grinnell Regional Medical Center is a healthcare system that includes Optimal Healing Environment through their facility and services.  Their Optimal Healing Environment encompasses the internal, external, behavioral, and interpersonal environments.  Massage therapy, healing touch therapy provided by GRMC help enhance healing by reducing pain, and anxiety through theses services.   Spiritual care is offered at GRMC individualized to the persons spiritual needs. GRMC has “healing spaces” on campus where patients and guest can stay in to find relaxation.  The Healing Garden is an outdoor garden with benches, sculptures, and flowers where patients and guests can enjoy nature.  The facility has a huge collection of Art, and an art gallery using Art Therapy enhances healing.  GRMC is a tobacco free campus, and provides healthy meal choices for patients and guests.

Professional Presence Promotion

As an Oncology Nurse at The Mount Sinai Hospital, self-awareness, understanding own values and beliefs will help me improve professional presence.   The Mount Sinai Hospital is located on the Upper East Side in New York City.  It serves a very diverse community, from different socio-economic backgrounds.  As a cultural competent nurse, and patient advocate, understanding the physical, psychological, spiritual and social needs of the patient will help promote wellness and result in positive outcomes.  Understanding that healing focuses on the “whole person”, creating healing relationships, promoting healthy lifestyle choices, and incorporating external healing elements will help improve my role as a nurse and patient advocate.   Self-awareness, understanding my own beliefs and values will allow me to grow professionally, and help patients that we serve in the healing process

Professional Presence and Influence Homework