Nursing Leadership Professionalism:

Nursing Leadership
Professionalism: Nursing Leadership

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respond to 3 of my classmates discussion post with at least 250 words. I need to add on to the discussion to further the discussion by adding information.. maybe
state what you thought was interesting and add information to further discussion.

The original discussion topic was:” Professional Behaviors The concepts for this module include Professional Behaviors, Commitment to the Profession, Leadership
Principles, and Work Ethic. We all know and have worked with people who have lacked professionalism. Not only is this unpleasant to work with, but it puts our patients
at risk. I also want to talk about leadership principles. I’m sure you have all worked with many different types of leaders. Just as there are many different types of
leaders there are many different leadership theories. Even if you think “I’m a long way away from being a nurse leader, I’m still just a student” – this isn’t true.
Every nurse is a leader in many ways. Learning now what makes an effective nurse leader can help you to realize your potential. For this discussion I want to you to
put together a presentation about professionalism. For example, you might share what makes an effective nurse leader, but don’t stop there. If you choose to share
this, also share examples you have encountered. What makes an effective nurse leader? How can you be an effective nurse leader? What situations have you encountered
where an effective nurse leader could have made a difference? These are just a few of the items you could consider for this discussion. You may choose any part of this
module to focus on, just make sure you also include scholarly resources to support your discussion. “

Discussion 1
This discussion is about professional behaviors in which I feel is so important in any job or career and not just in nursing. As our book states that it’s important to
not confuse leadership with management. A manager has an official position and is in charge of running an office or development. A leader does not have an official
position to lead. Also in our book on page 2490 it lists a bunch of effective qualities that a nursing leader could have. For example, some qualities that I feel like
are key to being a leader are; being passionate and committed, direct client care, knowledgeable, being organized, attendance, accountability, and work ethic.
Being in a profession where your behavior matters at all time, it is important to be professional. An encounter that I have come across is in appearance. At the clinic
I work in, a new hired nurse walks in to work with leggings and high heels on. Appearance is vital and it is a form of nonverbal communication. I don’t think a patient
would be confident in the nurse or be comfortable to express any concerns in their care plan while being inappropriately dressed. An article that I came across had to
do with smoking and health education that influences nursing students. The purpose of the study was on the health consequences of smoking. The results of the study
were that the students that smoked had less favorable attitudes and behaviors toward the prevention of smoking, which I feel this could tie into knowledgeable and
committed to your profession. When we are educating our patient about the prevention of smoking and the risk factors and not being fully committed or passionate about
it, I feel that it does not show leadership at all. Another encounter I have experienced, I am a circulator in procedures and on this one procedure the nurse and
physician were joking around and laughing. A funny comment was made and the nurse flipped off the physician. I was very shocked and surprised. It was very
unprofessional.

Discussion 2
Leadership is needed in society. From the Starbucks Coffee down the street to the large hospital with 10 different medical units. The important role of leaders is to
lead people, whereas in contrast; managers manage objects. Leadership is defined by everyone differently, but one common factor can be observed by most. Leaders
usually have followers for a similar purpose and believe their leaders purpose. Leadership is not a task that can be handed down or easily replicated by others. What
makes someone a leader over others? What makes a person different than a manager of things?
According to St. Thomas University, the qualities of decisiveness, empathy, awareness, accountability, confidence, optimism, honesty, focus, and inspiration are
mentioned as key elements to bring an individual up to leadership. A person will see measuring data, organizing, setting objectives, and communication as a manager
(Spahr, 2015). The role of a leadership utilizes the human emotion to make change by way of inspiration and empowerment. A person empowering others is a single quality
alone that makes a leader a unique role!
As a nurse, they will not only become a leader to patients. The patient’s family members, the front-line staff, the housekeeper, the maintenance man, and the physician
are all part of the collaborative care team that need them to show leadership. Styles of leadership vary by personality, upbringing, and environment. Some examples of
leadership styles include charismatic, innovative, command and control, Laissez-faire, Pacesetter, servant, situational, and transformational. Each leadership style
offers a unique approach to the social environment involved guaranteeing that there is no correct or incorrect style of leadership (Spahr, 2015).
Servant leadership is my preferred leadership style in the work environment. A leader who is willing to serve their followers/employees can a humble attitude and
promote teamwork. Positive attitude is mentioned by Alexander in Nursing: A Concept-Based Approach to Learning as an important piece of professionalism. The nurse that
is optimistic helps affect those in their environment (Alexander, 2015).
What can we do to become better leaders than yesterday? We can look to our leaders in history that shaped the books we read today. Rosa Parks was a leader and said
“No.” when she could have continued to be a follower. We can question ourselves, “What do we want to change?” “What can we make this better?” Her leadership changed
the world and is an example of inspiring people and notions. Are you going to a first follower, like Rosa?
We can ask ourselves after before each nursing report what we can do to be a leader on the floor that day and reflect after our shift on the time spent with others.
Was our time spent being leaders? Was our time spent questioning the integrity of nursing and being advocates for our patients and staff? Lastly, the basic question:
what was our intention for this shift? If the answer was not to provide quality care, we can identify that something may need to change.

Discussion 3
What is professionalism? According to our book, professionalism is “acting with knowledge, skill, and preparation of a professional.” The way a person is dressed,
the tone of their voice, their body language, and their approach to any given situation are all important pieces when talking about professionalism. I think an
effective nurse leader is someone that has worked very hard in becoming a leader. Someone who is approachable and listens. Appearance is important, following the
dress code set forth by the facility or company. If there are rules about tattoos being covered up, no jewelry, hair pulled back etc. It is important for the nurse
leader to follow these guidelines to show professionalism to co-workers. Communication skills are one of the most important skills to have as a nurse leader.
Effective communication is so important in order to communicate with your team productively. A nurse leader is knowledgeable about his or her profession and able to
teach others what they know but is also able to learn from others as well. To me a nurse leader is someone that listens, doesn’t take sides or stays neutral in
disagreements, is able to communicate effectively, stays calm in stressful situations, approachable, a team player, helpful, knowledgeable, and able to discipline when
appropriate without breaking confidentiality.

answer the following question:
Imagine that you are a charge nurse of a busy unit. You are responsible for making staffing assignments, and every time you make staffing changes a particular nurse
gives you “push back”. How do you manage this? How can you be effective as a leader with this type of attitude?

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Posted on September 14, 2017
Schizophrenia/ Antipsychotic: Ability us
Schizophrenia/ Antipsychotic: Ability use

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rеspond to 3 of mу clаssmates dіscussion post with at least 250 words. I need to add on to the discussion to further the discussion by adding information.. maybe
state what you thought was interesting and add information to further discussion.

Discussion 1:
Abilify, or aripiprazole is a medication known as an atypical antipsychotic or second-generation antipsychotic. Some common side effects of Abilify include nausea,
vomiting, headache, constipation, anxiety, feeling restless, tremors and insomnia. (NAMI, 2016).
Extrapyramidal effects (EPS) and tardive dyskinesia (TD) are two side effects that involve muscle movement and excitation. EPS symptoms include stiffness, tremors and
restlessness while TD symptoms include slow or jerky movements that cannot be controlled and they often start with tongue rolling, smacking of the lips, sucking,
grimacing, or movements that mimic chewing. If these symptoms should appear it is important to contact your healthcare provider immediately. (NAMI, 2016). The AIMS is
an Abnormal Involuntary Movement Scale and patients taking first or second generation antipsychotic medications should have this completed regularly to monitor for
tardive dyskinesia.
Although schizophrenia has an early adolescent onset, it is important that as the patient ages, their current needs are assessed and met. As the patient ages, they
are at greater risk for adverse effects to medication (Jeste & Maglione, 2013). Symptoms of schizophrenia tend to become less prominent and severe with age so in the
case of this patient it is important to assess the side effects he is having and decide whether or not they are related to the disease itself or to the medication he
is taking. “Treatment plans for older adults with schizophrenia must consider the effects of age on the course of the illness as well as on the response to
antipsychotics and to psychosocial interventions.” (Jeste & Maglione, 2013). The patient should be monitored closely to ensure that the risks of treatment don’t
outweigh the benefits. In a study done by Jeste and Maglione they found that there is a natural tendency for improvement of symptoms but an increased risk of adverse
effects to medication with age. Because of this it has been found that as the patient ages it might be appropriate to decrease the dose of medication by about 50%.
It is important to education the patient on the risks of missing a dose or stopping the medication without consulting their physician first. Missing a dose can
increase the patients risk for relapse of symptoms so it is very important that the patient continue to take his medication and talk with his physician before stopping
or making any changes. This could be the cause of non-compliance for the patient. If a dose is missed it should be taken as soon as the patient remembers unless it
is close in time to when the next dose would normally be taken. Alcohol and illegal drugs can decrease the effectiveness of Abilify so they should be avoided.

Discussion 2:
Abilify (Aripiprazole), third generation class of antipsychotics/ dopamine-serotonin system stabilizer (DSSs), Abilify is used to treat schizophrenia, bipolar
disorder, depression, and Tourette syndrome. Abilify can control both the positive and negative symptoms of schizophrenia. Adverse effects include dizziness,
lightheadedness, drowsiness, nausea, vomiting, tiredness, excess saliva/drooling, blurred vision, weight gain, constipation, headache, and trouble sleeping.
When taking antipsychotics medication you have to be careful with other interactions with medications, food, alcohol, and smoking. Given the information, I have
George’s needs to tell me more about his history to help investigate more into his symptoms. Some following questions I would ask are. Are you on any other medication?
, Any alcohol or drug abuse? , Can you explain to me some of the symptoms you feel while taking the medications?
Extrapyramidal effects- there are four sets of adverse reactions to antipsychotic drugs, acute dystonia, akathisia, Parkinsonism, and tardive dyskinesia.
Acute dystonia: severe spasms, back muscles, tongue, and facial muscles; twitching movements.
Akathisia: constant pacing with repetitive, compulsive movements.
Parkinsonism: tremor, muscle rigidity, stooped posture, and shuffling gait.
Tardive dyskinesia: bizarre tongue and face movements such as lip smacking and wormlike motions of the tongue; puffing of cheeks, uncontrolled chewing movements.
When experiencing extrapyramidal effects they can be managed by an anticholinergic agent such as Benztropine, (Cogentin), diphenhydramine (Benadryl) and
trihexyphenidyl (Artane), also dopamine agonist agent’s pramipexole.
Tardive Dyskinesia: a condition affecting the nervous system, often caused by long term use of some psychiatric drugs.
Tardive Dyskinesia cannot be cured but treatment can help revert back to semi normal function. Medications like sedatives may help, discontinue or taper down
antipsychotic drugs, seeing a specialist like a neurologist or a psychiatrist who treats mental disorders.
My assessment for George, I want to start with a baseline assessment, viewing his health history, obtain Vital signs, Labs, history of depression, current medications,
and assess for EPS. I am concerned with his noncompliance to the daily drug regimen, showing repetitive tongue movements, and his body temperature. Also, another
concern about Abilify is taking the max: 30mg/day, I would undergo evidence base practice by finding information about Abilify being tapered up to the max dose.
George’s noncompliance is a concern and giving his age and wife states she does not like Abilify either has me thinking they may not know one of Abilify’s side
effects. Abilify can cause low libido. Many antipsychotic drugs increase prolactin levels which can lead to decreased libido. High prolactin can cause lack of libido,
impotence, or gynecomastia and another side effect is weight gain. Talking to the health care provider to give them options to medications that will not lower libido
may help with the noncompliance.
Patient teaching- the patient will be compliant with the daily drug regimen, also understanding and recognizing adverse effects.
• Compliant with daily drug dose
• Patient will address any concerns he/she may have
• Address safety issues being noncompliant with medication dose
Involve patient and caregiver to remain on a regular. medication routine.
Instruct patient or caregiver to report EPS for additional treatment.
Encourage patient or caregiver to record a weekly weight.
Encourage a healthy diet and exercise.
Address any sexual concern to health care provider.
Patient or caregiver should state the reason for the drug and appropriate scheduled dose.

discussion 3:
Abilify is an anti-psychotic medication used for treatment of psychotic conditions and disorders such as schizophrenia and bipolar disorders. This medication is also
used for treatment for depression. The mechanism of action of this drug is that is binds to a number of CNS receptors. One of the receptors that has a huge role in
this drug, is the dopamine receptor which relieves positive symptoms for this drug. This drug also helps stabilize both dopamine and serotonin levels in the brain. The
adverse reactions and side effects of this medication are; drowsiness, sedation, nervousness, insomnia, manic reactions, orthostatic hypotension, tachycardia, dry
mouth, incontinence, sweating, dry skin, and hypoglycemia.
In George’s situation, I would want to know more on if there were any life or traumatic events that have happened since he has stopped the medication. Why does his
wife Sheila not like this medication. How long the symptoms have been going on for. Is there anything that is bothering him at home or in his personal life. With his
appearance unkept and body odor the physical assessment makes me wonder if things are okay at home or if there are any illegal substances being used. Extrapyramidal
effects are a particularly serious set of adverse reactions to antipsychotic drugs. These symptoms include acute dyskinesia and dystonic reactions, tardive dyskinesia,
Parkinsonism, akinesia and akathisia. The treatment for this effect is medication; depending on the symptom the medication that will be used will be different. For
example, according to this article on NCBI, treatment for acute dystonia can be diazepam; this can be used as an alternative therapy to help with symptoms. Along with
tardive dyskinesia treatment of clonazepam can be used to help manage this condition. This condition affects the nervous system which is caused by the use of
neuroleptic drugs for prolonged periods of time. The symptoms are unpleasant it causes the body to have involuntary movements and grimacing.
I would want to assess any chemical alterations such as if George taking other medications that would contribute to this effect and also checking his electrolyte
imbalance. Having a healthy support system is important. For example, Shelia she states that she does not like Abilify. Assessing our patient’s support system is
important because we are an advocate to them. We want the best for our patients, if we assess unhealthy or negative behaviors with their support system we can educate
our patients on the contributing factors that can lead to noncompliance down the road. As I stated above I would be sure to assess any stressful events that could have
caused fear or anxiety. Educating a schizophrenia patient could be difficult but I would encourage them to have healthy habits to improve functioning; maintaining
self-care and having a regular sleeping pattern. Showing empathy with George’s feelings will help reassure my interest and care. I would also educate and teach coping
skills that help minimize worry; for example, going to the gym, talking to someone he trusts, and playing the tape through. Teaching these different strategies can
help when he is alone.

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