I am asked to do a new procedure by physicians in my workplace.
1. First I would ask myself, “Is this in my nursing scope of practice”. Check in with what I find concerning, and also what positive effect this new practice will have related to patient care.
2. Then gather all information on the new procedure available.
3. I would discuss with my head nurse/supervisor. Review any new ideas or concerns my supervisor may have.
4. I would review patient rights.
5. I would call the nursing practice board in New Mexico, and review it with the gentleman Derek I usually talk to when I have questions. Derek and I are well acquainted, from previous questions and requests of interpretations of Nursing Practice Act in N. M.
6. I would discuss the new process with Human Resources with whom I am also I have had contact with, in regards to previous questions, they are very helpful.
7. I ...view middle of the document...
12. Appoint a committee with a nurse directing the committee, this committee will observe new processes related to this new procedure and verify any current practices. A committee can be appointed first, to gather all information, or can be appointed once research is done.
13. Train and educate all nurses and nurse assistants. Start with a small group on the unit. Slowly introduce to all staff, reviewing all concerns carefully.
An example of this scenario occurred at my place of employment. A doctor wanted to train all nurses and medical assistants to teach behavioral training. This new training is called Dialectical Behavioral Training. This training is usually done in therapy by a licensed therapist. After reviewing the scope of practice, and gathered all the previous information, the committee prepared the documentation to follow the scope of practice. The change included citing this treatment as a group and not a therapy session. This was presented appropriately in the treatment plan. They could have groups teaching DBT, but they could not train in a therapy session, which changed the care plan of the nurse and staff. This change in care plan differentiated a therapy session to a teaching group. This was a very important piece, in regards to scope of practice.
Then the DBT group training started with a small group in a small unit. All members of small unit sent to Pesi seminar specializing in DBT. Then a formatted plan was rolled out to be reviewed after 3 months. Of course the small group wasn’t as invested initially. Due to the fact that changes isn’t always easily welcomed. After a year, there was positive response and increased “buy-in” from the staff regarding DBT. Today these DBT groups have taught patients new coping skills every day, which is tremendously important. The new process has been highly successful. And after a year, most staff felt empowered to have this new skill.
Creasia, J.L., Friberg, E.E. (2011). Conceptual Foundations: The Bridge to Professional Nursing Practice.