NURSE 730 PRACTICUM PROPOSAL PLAN1
Nurse 730 Practicum Proposal Plan
Cheryl Miller
Ferris State University
NURSE 730 PRACTICUM PROPOSAL PLAN1
Abstract
This practicum proposal plan describes the intended goals, objectives, and activities to be completed during the 2014 summer semester at Ferris State University.This graduate student nurse will join Mrs. Christa KiesselMSN, ANP, APRN-BC and a multidisciplinary team of physicians, nurses, radiology technicians, pathologists, and directors to establish a formal Breast Center at Munson Medical Center. The aim of this center is to integrate and streamline breast care delivery. Breast Centerproject goals include writing a formal business plan, establishing a breast program leadership (BPL) team, reviewing accreditation standards, achieving accreditation, establishing bylaws, developing a formal budget, and more. This nursing leadership practical experience will provide insight and understanding of integrated care delivery.The ways in whichnursing administrative leaderscontribute to effective health care delivery will also be evident.Furthermore, this experience will provide this student an opportunity to apply nursing theory andintegrate two Standards of Professional Performance, Standard 7: Quality and Standard 11: Collaboration, as outlined by the American Nurses Association (ANA) (2009). The following discussionacknowledges the need for integrated cancer care deliveryin northern Michigan anddescribesthis student nurse’seducation and experience,the proposed setting, proposed timeline, preceptor information, intended goals,andevaluation tools to measure overall success.
Keywords:Breast Center, practicum proposal plan, integrated care delivery
NURSE 730 PRACTICUM PROPOSAL PLAN1
Nurse 730 Practicum Proposal Plan
Rapidly changing health care settings and evolving patient care needs create a unique mix of challenges for nursing administrative leaders.As such, organizational resources must be carefully managed and patient care strategiesmust be restructured in order for health care institutions to be successful in their mission to provide quality and cost effective care.Quality patient care must be at the center of all nursing leadership decisions (ANA, 2009). A nursing administrative leader hasorganizational authority and must continually strive for excellence while shaping the health careenvironment in which they serve (ANA, 2009). Two key aspects of a nursing administrator role are evaluating patient care services and revising organizational systems to support quality patient care delivery.The Institute of Medicine (2010) defines quality patient care as provision of medical services that are appropriate, technically sound, and culturally based with shared decision making between health care professionals.
Achieving quality patient care outcomes is dependent upon knowing the current and future patient care needs of the population being served (ANA, 2009). Insight gained through a community assessment provides leadership guidance.Munson Medical Center (2013) reports that 1,500 patients receive a cancer diagnosis each year and that 20,000 new cancer diagnoses will occur over the next 10 years in the five county regions surrounding northern Michigan. As a result of these findings,organizationalefforts are underway for the development of a state of the art cancer center which will integrate care delivery for these patients.A formal breast center is being planned in 2014, as part of this coordinated cancer care delivery system. Diagnostic screening and breast care service delivery across a variety of settingsincluding physician offices, a proposed multi-disciplinary clinic, Munson Medical Center,and someaffiliate hospitals is planned. Thompson (2009) finds that benefits of establishing a formal breast center include improved: screening, care delivery, patient outcomes, recruitment of physicians, a patient referral process, and better utilization of services through team efforts and collaboration. The breast center is designed to have multiple specialists available in a single setting so that breast care delivery is better coordinated and expedited. Specialty consultations include oncology, radiology, pathology, general surgery, nurse navigators, social work and more. The patient benefits by not having to travel to multiple appointments and patient care is more efficient.
Planning, developing and implementing an integrated patient care delivery system, such as a formal breast center,is broad in scope. As such, a novice nursing leader can obtain a wide range of learning experiences through interaction with a multi-disciplinary team of health care providers and through achievement of a variety of clinical leadership tasks. These tasks include writing a business proposal, developing breast center bylaws, establishing a formal budget plan, choosing BPL team members, applying and achieving accreditation, and more. In addition, the process of developing a formal breast center requires organizational leadership decisions which directly impact patient care delivery.Therefore, it is a perfect fit for this nursing leadership practical experience.Thus, the purpose of this paper is to present a detailed action plan to build on and ultimately achieve nursingadministrative leadership knowledge, skills, and experience throughthis planned practicum experience and clinical leadership project.
Practicum Project
In conjunction with thisplanned nursing leadership practicum experience, this graduate student nurse willactively participate in developing a formal breast center business plan, recruit and formalize a breast program leadership team, review the National Accreditation Program for Breast Center (NAPBC)accreditation standards by the American College of Surgeons (ACS) (2013), assist in application of NAPBC accreditation, assist in the formation and approval of breast center bylaws, assist in the development a formal budget, and more.Clinical project tasks will be collaboratively chosen with direction from Mrs. Kiessel, my project preceptor and leadership mentor. Breast centerteam members will includedirectors, physicians, pathologists, nurses, radiologist, social work, and others. Porter-O’Grady (2011) finds that partnering with other health care professionals to coordinate patient care practices helps to ensure quality care, increased access to services and increased value. The Institute of Medicine (IOM) (2010) finds that nursing leadership must partner with other health care leaders to collaboratively plan, establish goals, and continually evaluate efforts in order to ensure safe and effective patient care practices (IOM, 2010). Participation in this clinical project and leadership practicum plan will fosterattainment of knowledge related to the role of nursing administrative leadership, integrated care delivery systems, and the promotion of quality breast care. Careful assessment, planning, and collaboration are key leadership skillswhich will be utilized to promote successful achievement of project goals.Wagner et al., (2013) finds that cancer care systems are often fragmented, resulting in lack of coordinated care delivery, increased costs, care delays, and inadequate social support. These identified barriers provide crucial evidence of the need to integrate breast care delivery and streamline patient care.
As such, it is the goal of this graduate nursing student to utilize past academic knowledge ofa Bachelors of Nursing Degree and Masters level nursing classes to guide in the planning, development, and implementation of this nursing leadership practicum experience. Masters level classesinclude knowledge of health care delivery, advanced nursing roles, leadership practices, nursing theory and research, and project management. In addition,this graduate student nurse hasover twenty years of experience in acute care setting in medical surgical care, cardiology, shift coordination, nursing administrative supervision, transfer coordination, and more. Thisacademic knowledge base and nursing experience provide a solid foundation from which to base nursing practice decisions.However, limitedleadership experience andlimited knowledge ofthe out-patient medical care arenais an area of weakness. As a result, this graduate nursing student is considered a novice nursing leader.
Through this planned practical experience, this graduate student nurse seeks to gain nursing leadership knowledge, skills, experience, and confidence by actively participating in the planning, development, and implementation of a formal breast center program at Munson Medical Center. MacPhee, Chang, Lee and Spiri (2013) find that a collective leadership approach, rather than an individual approach is best when managing complex health care challenges in diverse settings. Therefore, this student nurse will be working collectively with Mrs. Kiessel to achieve breast center project goals. This practical leadership plan willprepare this graduate student nurse for the advanced specialty role of nursing administrationthrough attainment of increased knowledge of breast care service delivery, mentorship with senior nursing leaders, and active participation in one or more of the following project goals: achievingNAPBC accreditation by the ACS (2013), developing breast center bylaws, writing a formal business plan, developing a formalized budget, collecting breast center data, standardizing breast care practices, and more. In addition,Standard 7: Quality of Practice and Standard 11: Collaboration, as outlined bythe ANA (2009) inthe Nursing Administration: Scope and Standards of Practice, will be integrated during implementation of this clinical project.Additional knowledge related toNAPBC accreditation standards, breast center bylaws, standardized breast care practice, data collection, case review, and budget development will be attained. Professional growth through mentorship, role modeling, sharing information and feedback, participating in the review ofbreast care practices across the out-patient and in-patient setting, promoting collaborative communication with a multi-disciplinary health care team, and developinga greater self-awareness ofstudent leadership strengths and weaknesses is planned. Theseactions are consistent with core competencies outlined for leadership directors at Munson Medical Center (2013) which includes relationship building across professional levels to promote quality care outcomes, promoting collaborative communication through engagement, and identifying opportunities for self-improvement.
Setting
The setting for this nursing leadership practicum experience will be Munson Medical Center, a magnet designated, non-profit, 391 bed acute care hospital and regional referral center located in northern Michigan. Munson Medical Center serves the medical needs of residents living in22 surrounding counties and is dedicated to providing superior and quality patient care services (Munson, 2013).The need for an integrated cancer care center has been identified as a critical need for residents of northern Michigan (Munson, 2013). Munson Medical Center is planning a state of the art cancer centerwhich will include Stereotactic Radiosurgery (SRS) equipment, expansion of the infusion clinic, and a more coordinated approach to providing cancer care services across affiliate settings, physician offices, a multi-disciplinary clinic, and Munson Medical Center (Munson, 2013). This graduate student nurse will be participating ina variety of multi-disciplinary meetings at several locations within the Munson Medical Center campus including the Lung Clinic, the Smith Family Breast Center, the REMEC Center, the Administrative Boardroom, Mrs. Kiessel’s office, Mrs. Garthe’s office, and more. Key leaders include nurses, oncologists, general surgeons, radiologists, pathologists, social work, informatics, and hospital administration.
Practicum Goals
Thegoals of this nursing leadership practicum experienceareto foster professional leadership growth through the attainment of knowledge, skills, and experience and develop into the advanced specialty role of nursing administration by integrating Standard 7: Quality of Practice and Standard 11: Collaboration as outlined by the ANA (2009) during the 2014 summer semester at Ferris State University.This graduate student nurse will be mentored by Mrs. Kiessel MSN, ANP, APRN-BC, and Interim Oncology Service Line Director, who is responsible to plan, develop and implement a formal breast center at Munson Medical Center. MacPhee, Chang, Lee and Spiri (2013) suggest that leadership development is enhanced by learning along with others and results in greater innovative thinking, a systems level approach to problem solving, personal empowerment, self-confidence, and relationship building.Frankel (2009) also finds that a mentoring relationship offersincreased self-esteem, emotional support, and increased confidence through the attainment of new knowledge, skills and experience.Other important aspects include documenting what is being learned, discovering strengths and weaknesses, role modeling, coaching, and future goal development (Frankel, 2009). These principles will be utilized in this synthesis of this practical leadership plan.
Practicum Objectives
The following objectives support this graduate student nurse’s professional goals to gain leadership knowledge, skill, and experience during the 2014 summer semester at Ferris State University. The first planned objective is to increasepersonal confidencethrough mentorship and collaboration with Mrs. Kiessel. As a novice nursing leader, mentorship with an experienced nursing leader allows for the practice of leadership skills within a safe and supportive environment, role modeling, coaching, and feedback.This mentoring relationship fosters learning by reducing fear or the risk of failure. Frankel (2009) finds that nursing leadership is responsible to guide novice leaders, share their wisdom, and enhance the practice environment. Sharing ideas and offering feedback at BPL meetings, basecamp activities, weekly preceptor meetings, and the multi-disciplinary lung clinic will allow for team building, collaboration, and effective decision making. Hands on participation in attainment of breast center project goals will lead to increased leadership knowledge, skills, and experience. Furthermore, Janes (2008)finds that nursing mentorship leads to a greater self-awareness and increased willingness to learn from one’s mistakes. This allows for personal growth.The second planned objective is to seek knowledge though research of breast care practices and nursing leadership practices to build upon my current knowledge base. This will foster student learning, professional growth, andcredibility as a breast center team member.Having a solid base level of knowledge related to breast care delivery will enhance the ability to participate in team decision making and project goal delivery. The third planned objective is to seek professional development through attendance of webinars, breast care conferences, or other educational opportunities.In doing so, this will contribute to myunderstanding of the current trends and challenges within integrated breast care delivery, as well as, possible leadership strategies to overcome them.Education is an ongoing expectation of being a professional nursing leader. The fourth planned objective is to integrate Standard 7: Quality of Practice(ANA, 2009) byparticipating in assessment of breast care delivery in conjunction with Mrs. Kiessel and BPL leadership staff.Enhancing quality care delivery is a primary responsibility of a nursing administrative leader (ANA, 2009). Knowledge of the breast care practice environment along with knowledge of NAPBC accreditation standards will guide leadership team decisions targeted upon standardizing and optimizing breast care service delivery.Tzenalis and Sotiriadou (2010) find that health promotion requires a team effort, collaboration, and a sharing of knowledge and skills. The complex nature of health care delivery demands partnership and teamwork. The last planned leadership objective is to integrate Standard 11: Collaborationwhich is crucial toward successful achievement of breast center goals.Ongoing communication with a multidisciplinary team is a major component of this clinical project and practicum experience. Tzenalis and Sotiriadou (2010) state that multi-disciplinary collaboration results in improvements to standards of care, greater team accountability, and greater team satisfaction.Communication with Mrs. Kiessel and BPL team members using Watson’s (2008) Philosophy of Science and Caring principles will promote effective team building, trust, and sharing of information.Jean Watson's Philosophy and Science of Caring (2008) principles will serve fostercollaboration, mutual respect, and open communication.Developing a helping trusting relationship and being authentically present in a learning environment can foster mutual understanding and trust according to Watson (2008). The benefit of sharing information with colleagues is that new ideas or solutions may come to light which could foster achievement of breast center project goals.
Practicum Preceptor
I have obtained verbal and written permission from the following preceptors for this practicum experience. Mrs. Christa Kiessel, MSN, ANP, APRN-BC, Interim Oncology Service Line Director, who will be leading efforts to develop and implement a formalized breast center in Traverse City, Michigan. The intention of this project is to coordinate breast care services between Munson Medical Center, its affiliate hospitals, and out-patient settings in order to streamline and improve patient care. These plans complement work already underway for a future, state of the art cancer centerat Munson Medical Center.Mrs. Kiessel has worked as an oncology nurse practitioner at Munson Medical Center with a primary responsibility to develop, coordinate, and care for patients at the Cancer Genetics Clinic (Munson Medical Center Intercom, 2014). She is currently responsible for the development of clinical programs and processes to enhance quality patient care services related to oncology services (Munson Medical Center Intercom, 2014).This is Mrs. Kiessel’s first preceptor experience, so she will be working under the expert guidance of Mrs. Kathy Garthe, MSN, Administrator and Outreach Coordinator at Munson Medical Center. Mrs. Garthe has over 20 years of nursing administrative leadership experience and has served as a preceptor to 12 other Master’s Degree nursing students. I have worked indirectly with Mrs. Garthe for seven years and she is highly motivated, energetic, and professional. She is an excellent role model and nursing leader.
Practicum Role and Activities
This graduate student nurse’s role during this 2014 leadership practicum experience is to actively partner withMrs. Kiessel, MSN, ANP, APRN-BC and the multi-disciplinary breast center teamto achieve one or more of the following ideals: NAPBC (2013) accreditationof the breast center, establishment of a formalized budget, standardization of breast center services, development ofbreast center bylaws, breast center data collection, and more.Furthermore, my role will be one of learner and novice nursing leader who will be seeking knowledge through mentorship and role modeling experiences. This mentorship, along with theproposed clinical project goals,supports the attainment of nursing administrative leadership knowledge, skills, and experience. Frankel (2009) finds that the role of mentorship fosters development of new skills, boosts confidence, and allows for discovery of leadership strengths and weaknesses. Other important aspects of an effective mentorship role include open communication and free exchange of ideas (Frankel, 2009). Therefore, collaborative and open communication will be utilized throughout this practicum experience plan. Planned participation in the development of a formal written business plan, establishment of breast center bylaws, achievement of NAPBC accreditation, and formalization of a budgetwill provide this graduate student nurse hands on leadership experience. Additional planned leadershipactivities include joint attendance and participation in BPL meetings, breast center basecamp discussions, one on one preceptor meetings, and attendance and participation in the multi-disciplinary breast clinics to foster further leadership understanding necessary for achievement ofbreast center project goals. Next, planned leadership activities to seek information through literature research supportthe ability to actively partner with the breast center leadership team.A literature reference list and bibliography will be compiled by May 2014 for ease of use. Literature will be reviewed for relevance toward integrating breast care delivery and nursing leadership. The next planned leadership activity supports the attainment of knowledge through attendance of webinars, workshops or breast center conferences by July 2014. Doing so, increases knowledge base related to breast care service delivery and integration of care. In addition, this graduate student nurse plans to attend weekly preceptor meetings with Mrs. Kiessel to seek insight and further leadership knowledge, skills, and experience.Lastly,leadership activities to integrate Standard 7: Quality of Practice and Standard 11: Collaborationisplanned.Standard 7: Quality Of Practice includes nursing administrative leadership activities to promote enhancement of care delivery through credentialing, standards, regulations and development of policies, procedures and guidelines aimed toward improving breast care (ANA, 2009). Achieving NAPBC accreditation is a planned goal of the breast center which will help to standardize and optimize breast care service delivery.Planned leadership activities to attend and participate in weekly and monthly BPL meetings, multi-disciplinary clinic, and basecamp agenda meetings to plan, develop, and implement breast center goals support quality of practice through policy and procedural development according to NAPBC guidelines for practice. Lastly, Standard 11: Collaboration, in which health care professionals share information, document plans, and seekfeedback in order to enhance health care delivery (ANA, 2009) will be integrated. Ongoing communication with a multidisciplinary team is a major component of this practicum experience plan. This is evidenced by the necessity to meet regularly in order to formalize decisions. Jean Watson's Philosophy and Science of Caring (2008) principles will serve as a guideline for communication and collaboration with multidisciplinary team members in order to foster relationship building, support mutual respect, and gain a critical understanding of the unique needs of each medical setting in which breast services take place.