C351Professional Presence PDF

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Running head: PROFESSIONAL PRESENCE AND INFLUENCE 1

Professional Presence and Influence Suzanne Darby Western Governors University

PROFESSIONAL PRESENCE AND INFLUENCE 2

Nursing is a dynamic, complex profession that balances the art of healing and caring with the scientific knowledge to assess and perform duties to support patient outcomes. The nurse is often the patient’s first introduction to a healthcare experience. The nurse’s verbal and nonverbal reactions, behavior and communication patterns may set the tone for patients’ perceptions of how they will be cared for, how their needs will be met and if they will be listened to when speaking to the healthcare team. This reflective essay will explore how my professional and personal presence may better serve myself and my care community. I will focus on two models of health and healing, submit and analyze the results from my Jung Personality test, develop a personal mindfulness plan and lastly discuss optimal healing environments and ideas to further enhance my professional presence at my medical center.

PROFESSIONAL PRESENCE AND INFLUENCE 3 Professional Presence and Influence Models of Health and Healing Comparison of Different Models of Health With origins in Asia dating back over two thousand years ago, Eastern medicine focuses on how the mind and body are interconnected working parts that adapt to the internal and external environments to maintain health and healing. Based upon the concept of balanced qi, or vital energy, the qi is proposed to regulate a person’s spiritual, emotional, mental and physical balance and to be influenced by the opposing energy forces namely yin and yang (MedicineNet, n.d.). Additionally, there are five essential elements, i.e. fire, earth, wood, metal, and water in nature that represent different energies that interact with one another and these elements connect to vital organs of the body. Disease or dysfunction occurs when the negative and positive energies of yin and yang and these elements become imbalanced. Clinicians identify issues in these areas and assist in balancing these energies to maintain the harmony of the mind, body, and soul. Treatment choices focus on the restoration of the whole human and the individual’s ability to adapt and recover either through but are not limited to physical exercises such as tai chi or yoga, acupuncture, traditional herbal medicine, nutrition, and meditation. Health promotion and positive lifestyle teachings assist the individual in maintaining wholeness and channeling one’s healing process when there is a disease. Viewed as an alternative or unconventional methodology in the United States, this type of practice is often not covered by insurance or with limited reimbursement benefits and treatments may take longer before giving positive effects and outcomes. In contrast, Western medicine divides health from disease and treats the mind and body separately. Emerging in the mid-1800s, allopathic medicine developed as the primary model for

PROFESSIONAL PRESENCE AND INFLUENCE 4 Western medicine as a biologically based approach to healing using scientific and technological advances (The New Medicine, n.d.). This type of medicine treats the disease and its’ symptoms but does not look thoroughly how the individual has contributed to the condition or the root cause of the ailment. There is substantial use of pharmaceuticals to treat, alleviate symptoms, or eliminate the disease. Innovative technology and cutting-edge procedures offer patients interventions that may provide quick solutions so they may move on with their busy lives but may not provide therapeutic interventions or directives for healthier lifestyles to achieve healing of the whole person. Western medicine offers concrete judgments by viewing a physical injury as more valid and tangible than a psychological trauma which may be considered to be a character flaw or a cause of a psychosomatic illness. This conventional medicine is regarded as the norm in the United States, and insurance companies widely accept the scientifically based treatments. Models and Professional Presence Reflecting on my direct care practice, my view and perspective on how I care for patients has dramatically changed over time and differs significantly from the Western model of medicine. Unlike the Western model of medicine and in part to my own life experiences as a patient, I have developed a greater understanding of what it is to take care of the whole person. Knowing who I am from my beliefs, values and mind, body and spirit awareness, I am consciously attentive to how others may perceive me, and the empathetic quality care that I render. My patients are no longer identified just by their diagnosis but looked upon, as they should, as whole individuals that come to the medical center with their own stories. Their disease is not my only focus during their care. The patient’s healthcare journey is jointly rewarding, fulfilling and informative with emphasis on positive lifestyle choices such as exercise, coping skills or dietary modifications. Plans of care are developed and mutually agreed upon as

PROFESSIONAL PRESENCE AND INFLUENCE 5 individualized patient-centered models and not solely based on a disease process. When given the tools, education, and encouragement, most patients are receptive to listen if it means improved outcomes and possibly decreased hospitalizations. Obstacles that may hinder a pathway to health and well-being are identified and mutually discussed. When given supportive guidance and opportunity, I believe that people have the inner potential to find balance or homeostasis of the mind and body systems to restore wholeness in healing. Influence on Nursing Practice Nurturing the qualities of empathy, compassion and relieving myself from auto-pilot mode, I make a point to connect with each patient and family regardless of the situation and the pace of the day. I am consciously engaged with them as I perform my tasks. Through keen assessment, I note their readiness and age-specific abilities to learn and review their prior experiences and expectations. Spending time face to face and discussing and updating their plan of care with them are essential portions of my day to convey to my patients that I am a confident professional listening and collaborating with them during this journey. My attention is on them as individuals without undue distractions to educate and provide them with safe, quality care. Filtering out the noise and alarms on my unit by pausing and breathing helps to keep me balanced and in the moment as I travel between rooms before caring for the next patient, having to speak with a family member or after stressful situations. With a greater awareness of my behaviors and responses, I may better serve my patient population to ensure improved outcomes and satisfaction for all.

PROFESSIONAL PRESENCE AND INFLUENCE 6 Personality Preferences Personality Submission Assessment

Test Results Analysis ISTJ personality types’ defining characteristics include integrity, sound logic, dedication, and traditionalists who uphold rules and standards (www.16personaltities.com). The characteristics of this personality type align with my behaviors and reactions at work, home, and relationships. I am certainly viewed as being honest, dependable and responsible with what I set out to accomplish. With an emphasis on details, tasks are thought about intently and completed meticulously, timely and when completed give me great satisfaction. ISTJ’s perfectionism, however, is a self-limiting characteristic that may impede my view of seeing only the negative in something versus the greater good of a project goal or my performance professionally or personally. When the results of a task are less than what is expected, I am quick to blame myself for substandard performance. My responses are concrete and based on known experiences, directions and realistic ideas. There is nothing left to chance since I have planned out every feature with a focused goal in mind. I cannot function effectively in an unpredictable abstract environment. Spending time alone, an open, direct communication style and relating situations to facts are traits that align with my personal analysis. Preferences Alignment Evaluating the results of my test results according to family relationships, favorite activities and career choices were not surprising. As a parent, I am strict with rules and boundaries and expect my children to be respectable, and contribute positively to home life so they may mature as adults with strong moral compasses. Adding to the values within our home, traditions both old and new and in familial roles are integral to my structured lifestyle. I have a fulfilling, committed and stable relationship, and remain a dutiful, supportive and caring as a partner. However, with this, I may be interpreted as reserved in my emotional openness and often express my emotions through actions over words. In friendship, I do have a small circle of close friends who are like-minded in their perspectives. When meeting people for the first time, I may seem aloof or rigid, but it is my overall sense of taking in and observing what or who is around me. Recreational or social activities for myself and family are organized, purposeful and prearranged with a goal in mind to completion. When I set out to do something, it is indeed done methodically following the directions and placing a tremendous amount of effort to its’

PROFESSIONAL PRESENCE AND INFLUENCE 7 conclusion. Reading and television viewing is done for their practical applications of knowledge building and fact seeking. I love learning about new ideas so long as it is something that I can incorporate into my life to make things better. I prefer smaller intimate gatherings with friends and family as a comfortable social setting for me. I am in my comfort zone when planning parties by doing much of the backstage detail-oriented activities. Mingling in the crowd and striking up a conversation with a new group is not my forte. I prefer to stay with the familiar associations and shy away from discussions that may cause conflict. ISTJ personalities are often successful in career choices of law and order for the aspects of traditional rules and regulations, administrative or clerical roles for the details, as well as, in finances, mathematics or engineering for the systematic, logistical approach. Nursing may not fit as an interpretive career choice for my ISTJ personality. However, the analytical application of dutiful responsibilities and focus driven goals certainly align in this trait analysis. With given guidelines, rules, structured protocols and high expectations for quality care, I thrive in this stable, traditional career pathway choice through a hard-working, dependable work ethic. With the addition of enjoying educational opportunities, my need for objective information to sense and interpret my environment around me is fulfilling my well-being and job satisfaction. Using a checklist or routine approach to direct my workflow, I gain personal appreciation without expecting praise from my patients or care team when completing a job. Potential Challenges or Barriers Delegation and presentation of new ideas are two challenges that are self-limiting and add undue strife in my personal and professional life. Working through this exercise has made me reflect on why I negatively react or behave the way I do when these two areas do not align in my logical world. Delegation of tasks, duties or chores to others comes with the understanding that they will be done in a timely, responsible manner with attention to detail, pride, and organization. I grow increasingly insensitive when these matters are not prioritized or performed not to my standards. Before going ahead and doing the work myself, I must develop a greater understanding that we all work differently and I cannot impose my way as the only way to get to the endpoint. What I cannot do though is take on more of those responsibilities because it eventually leads to added stressors that are unnecessary both at home and work. I then concentrate only on what could go wrong and critique myself on those failures. Nursing has gone through an increased number of new initiatives all to support patient safety, quality of care and outcomes. Change is inevitable, but when change is happening rapidly against my known standards, it is often difficult for me to adapt. I need to review, analyze, see how this will best fit into my current work routine. I can be interpreted as inflexible by management since I challenge these initiatives by seeking out logical answers and rationales. I do not settle for the phrase “because that is the way we are doing things now.” I am a fact seeker and feel the need to express my opinion and give feedback on plans of action. I want to see the evidence-based practice model and how it fits into my care approach to enhance the patient care experience. With this and when working with others, I need to project beyond the short-term goals. Uncertainty should not be a barrier but a moment to proceed forward and efficiently to gain long-range goals. My objective assessment of protocols may be more widely received by others and members of the care team if I present my findings openly, concisely, with more significant presence and without judgment. Mindfulness Practice Whole Person Goals and Achievement of Goals

PROFESSIONAL PRESENCE AND INFLUENCE 8 Physical: I will increase my physical activity three days per week through a walking exercise plan. Having a nonstop schedule and putting everyone else’s needs before mine, I have become lax in exercising. Having a young dog is an excellent way for me to go for three 20-minute morning walks in the neighborhood after my children go to school. Free from phones, tablets or household interruptions, there is a local park that I can go to alone, as well, and get back to the music and scents of nature. Concentrating on my steps and mindful breathing can be energizing and calming as it frees my body of tension. In inclement weather, I can participate in the indoor walking club at our local mall as an alternative. I will eat healthier and select more balanced food choices daily by including five servings of fruits and vegetables in my daily food plan. On the go food choices and grab and go items often are not the best choices nutritionally. A weekly food plan incorporating fruits and vegetables that are nutritious, easy and economical can be prepared in advance. I will make my grab and go bags, prepared salads and fruit bowls and smoothies. By keeping a food journal on my phone, I can record, review and modify if I have not met my intended goals. Vital: I will get an adequate amount of sleep per night free from technology or television. Staying with a consistent bedtime routine, I will disconnect from all things electronic one hour before bedtime. Every evening, I will use my aromatherapy lavender spray on my pillow to benefit from the calming effects of this fragrance. Having an appropriate amount of restorative sleep, I shall feel energized and focused for the next day’s activities.

PROFESSIONAL PRESENCE AND INFLUENCE 9 I will balance my time between family, work, school, and hobbies by placing a centrally located planner in our home. A calendar posted on our pantry door will list all events, appointments, work schedules and school-related activities. I will review the calendar every morning and update it as events are presented. This visual reminder will lessen the stress for me, and I will have a more significant amount of organizational flow, control, and balance in my home without feeling overwhelmed or miss important items. Also, it will act as a learning tool to keep my children accountable and responsible without constant parental reminders.

Mental/Emotional: I will discuss daily one good and one not so good event of the day every evening. I utilize this reflective exercise at the dinner table or at the end of my workday to keep me engaged and grounded as to what is essential. I may voice both positive and negative emotions and speak about events. It is a mental cleansing for me, provides a means of problem-solving and a positive exchange of ideas. I will practice rhythmic breathing exercise just before my shift start time and after a stressful situation at work. For improved attentiveness, I will take a moment in the breakroom, and engage in Dr. Weil’s 4-7-8 breathing technique. Practicing a regular, mindful breathing exercise such as the Relaxing Breath can be calming and energizing and can have a lowering effect on my stress and anxiety levels (Weil, n.d.). Biographical/Spiritual I will partake in an introductory hatha yoga program. Once per week (Saturdays), I will take 30 minutes in the morning and participate in yoga within my home to focus on my inner

PROFESSIONAL PRESENCE AND INFLUENCE 10 core. Not only a great form of strengthening and flexibility exercises for my body, but yoga is also a workout for my mind through focused deep breathing and meditative relaxation. I will reconnect with my spiritual self by listening to guided meditation passages. Twice per week, I will participate in a 15-30-minute guided experience either through specialized videos or audios. A flow of energies both positive and negative can help me with my spiritual growth and self-awareness. It may strengthen my immune system, assist in recognizing my inner voice to improve my intuition or cleanse my whole self of negative emotions and fears.

Healing Environments Best Practices The Samueli Institute’s term Optimal Healing Environment (OHE) describes a healthcare system that is designed to inherently stimulate and support health and healing of patients, families, and their care providers (Sakallaris, MacAllister, Voss, Smith, & Jonas, 2015). Analyzing the environmental elements of internal, interpersonal, behavioral and external, I will discuss two OHE direct care facilities in the United States. Located in Lee County, Florida, Cape Coral Hospital is an acute care hospital of 290+ beds that also serves as a facility for health and wellness for the health care system and community. Through medicine as well as physical, psychological, spiritual behavior and social support, hospital administrators implemented this wellness initiative to benefit the patient’s overall well-being as well as healthier lifestyles for staff and the surrounding community (Johnson Engineering, n.d.). With an individualized focus on patient and family-centered care, Cape Coral values and understands that this input is welcomed in care making decisions. Patient

PROFESSIONAL PRESENCE AND INFLUENCE 11 rooms have cable television programming with educational offerings and dedicated thermostats for ambient temperatures. Innovative wellness strategies such as the Stair Wellness Exercise Program whereby interior stairwells were painted and redesigned to encourage stair climbing as a form of exercise to combat obesity are available for both patients, visitors and staff. Open to all, there is a Pathway to Discovery which encompasses four pedestrian connected outdoor areas each with a different focus. The Wellness Education Park is designed with various elevations, textures, and winding pathways to promote therapeutic outdoor rehabilitation and is open to the public. There is the Healing Garden near the Women’s Care and Birthing Suites which provides soothing sensory elements of nature to promote relaxation including benches amongst lush flora to admire. The Heart Healthy Reflection Pond not only has a lit fountain, but exercise stations and walking paths to improve physical fitness. In the Courtyard area, employees, as well as patients and visitors, may enjoy a fountain, and sit on sustainable furniture to encourage relaxation and revitalize while viewing picturesque eco-friendly landscaping. Preventative care initiatives are available that include yoga, mindfulness activities, and walking clubs. Various hospital-sponsored programs are available to area schoolchildren and adults to teach them about the importance of garden space, sustainable growing techniques, and...