NSG 4068 Reaching Out a Solution
NSG 4068 Reaching Out a Solution
What is the Issue?
The issue in the case study is about the automatic emergency defibrillator being not available when it was needed because it had been locked in the custodian’s closet. The school nurse discovered the issue during a recent athletic event where a spectator suffered a cardiac arrest in the stands. The coach of the home team went into the high school to fetch the defibrillator but could not locate it. The situation could have worsened had the emergency squad had not arrived and resuscitated the victim. Therefore, the focus of the analysis is to develop a solution that would prevent similar occurrences in the future in the high school.
Is it my Issue and Can I solve it?
The issue of the automatic emergency defibrillator being locked in the custodian’s closet and predisposing those at risk to danger is my issue and I can solve it. As a school nurse, I am tasked with the responsibility of ensuring health and safety for the stakeholders in the school and its environment. I have the responsibility to champion the adoption of policies that prevent unforeseen events similar to the above. I also have the responsibility of ensuring that the existing protocols and procedures in the school support the optimum health and wellbeing of all the stakeholders. As a result, I am best placed to explore effective solutions that can be adopted to prevent future occurrences of the above situation in the school. I can solve the problem by transforming the existing policies, protocols, and processes and increasing the level of awareness of the educational stakeholders on the importance of prioritizing safety and health.
Is this the Real Issue or Merely a Symptom of a Larger One?
The issue is a symptom of a larger one. Accordingly, educational institutions should have clearly developed protocols to be followed in addressing emergencies. They should have designated areas where emergency kits such as the automatic emergency defibrillator and fire extinguishers are kept. The institution should also eliminate bureaucracies in the access and utilization of kits being used in addressing emergencies. Therefore, the defibrillator being locked in the custodian’s closet is a symptom of a larger problem of laxity in the institutional policies and processes followed in case of medical emergencies.
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Does it Need and Immediate Solution, or Can it Wait?
The issue requires an immediate solution. Medical emergencies such as cardiac arrests are unpredictable. The young population, including high school students is highly predisposed to cardiac arrest. According to Atkins (2019), young people aged between 0 and 33 years are highly predisposed to hypertrophic cardiomyopathy, which is a common contributor of cardiac arrest among them. Cardiac arrest in such individuals develops irrespective of their engagement in any strenuous physical activity. Other risk factors for cardiac arrest such as obesity, hyperlipidemia, and inactivity among the young people also place them at an increased vulnerability to cardiac arrest (Baldi et al., 2018). As a result, the issue of the defibrillator being locked should be addressed immediately, since subsequent occurrences of cardiac arrests may arise unpredictably leading to worse outcomes in the institution.
Is it Likely to Go away by Itself?
The issue of the automatic defibrillator being locked rather than being easily accessed when needed may go away by itself. The institution may learn from the potential risks of having it locked, thereby, embracing interventions that will ensure its ease availability when needed in times of emergencies. However, the issue may fail to go away by itself if the school health nurse and other institutional stakeholders do not advocate and bring the issue to the administration of the institution. Consequently, it should be addressed immediately rather than waiting for it to resolve on its own.
Can I Risk Ignoring it?
I cannot risk ignoring the issue. Ignoring the issue will place the students and other populations at a high risk of poor outcomes such as mortalities should they experience cardiac arrest in the future. Ignoring the issue will also be a violation of my professional obligations. Accordingly, I am tasked with the responsibility of ensuring the populations that I serve have access to high quality, safe and efficient care. I also serve the role of being an advocate of the populations that I serve. I have the responsibility of ensuring that the policies and protocols used in the institution prioritize safety and health of the students (Yoder, 2017). Therefore, ignoring the issue will be a violation of my professional obligations as a nurse. I will be predisposing the students and teachers in the institution to adverse health outcomes, hence, the need for prioritized interventions to address it.
Possible Solutions and Risks to the Solutions
One of the possible solutions to the issue is reviewing and revising the protocols to be followed in the institution in keeping and accessing the automatic emergency defibrillator. The other solution is developing strict rules on the consequences of locking the defibrillator in private closets. The last solution is educating the educational stakeholders about the importance of ensuring easy access to emergency tools in the school. Some of the potential risks to the first solution include resistance from the school management and its stakeholders. The resistance may be due to the disruption of the existing status quo in the institution. The potential risk to the second solution entails the educational stakeholders not willing to support it due to the fear of the unknown outcomes. Education for the educational stakeholders may be expensive, hence, less likely to be adopted.
Steps Needed to Solve the Issue
One of the steps needed in solving the issue is forming a team to examine the problem, develop a solution and implement it. The team should comprise of the different stakeholders in the school. The second step entails assessment of the issue. The issue should be examined to identity facts associated with it. The facts will guide the development of solutions. The third step entails development of the alternatives that should be adopted. The team will list all the alternatives that apply to the situation. The fourth step is analyzing, prioritizing, and selecting the best alternative. The fifth step entails implementing the selecting solution and monitoring it to determine its successful utilization in the school (Nibbelink & Brewer, 2018). The last step is evaluation where the team assesses the effectiveness of the solution and communicates the findings to the stakeholders in the school.
Those Needed to be Involved in the Solution
Educational stakeholders should be involved in the solution. They include teachers, principal, other school nurses, prefects, and security personnel in the school. The above should be involved to ensure relevance and sustainability of the adopted solution. Their involvement will also ensure their empowerment to play a proactive role in examining additional interventions that can be adopted in the school to enhance safety and health of its stakeholders. Lastly, involving them will increase their responsibility in advocating safety and health in the school.
Power Leverage in the School
The school management is supportive of any change initiative that enhances safety and health of the students, teachers, and other stakeholders. It supports the implementation of evidence-based, realistic, and safe interventions that enhance the existing mechanisms used to ensure safety and health. As a result, it is highly likely that the school will adopt the proposed solution to address the issue. It will also strengthen the active involvement of the stakeholders to ensure the adoption of an effective and efficient solution.
Power in the Nurse
I possess expert power, which will enable me guide the adoption of an effective solution to address the issue. Expert power is a type of power that one acquires due to their level of knowledge and skill in an area that others do not have. The perception of expertise leads to such individuals having more influence over others in undertaking roles within their areas of specialization (Savolainen, 2020). I have the expert knowledge and skills on the promotion of safety and health in educational institutions. I also have knowledge and skills on the effective ways of forming teams to address safety issues in educational settings. I also have the expertise in the use of emergency kits such as the defibrillator in addressing chronic and acute health problems. Therefore, I will use the expert power to influence the decisions made to address the issue in the school.
Atkins, D. L. (2019). Sudden Cardiac Arrest in a Young Population: Not So Unpredictable. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 8(2), e011700. https://doi.org/10.1161/JAHA.118.011700
Baldi, E., Vanini, B., Savastano, S., Danza, A. I., Martinelli, V., & Politi, P. (2018). Depression after a cardiac arrest: An unpredictable issue to always investigate for. Resuscitation, 127, e10–e11. https://doi.org/10.1016/j.resuscitation.2018.03.027
Nibbelink, C. W., & Brewer, B. B. (2018). Decision-making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5–6), 917–928. https://doi.org/10.1111/jocn.14151
Savolainen, R. (2020). Manifestations of expert power in gatekeeping: A conceptual study. Journal of Documentation, 76(6), 1215–1232. https://doi.org/10.1108/JD-01-2020-0010
Yoder, L. (2017). Professionalism in Nursing. MedSurg Nursing, 26(5), 293–295.