Managing Complexity: Using the Monologue of Doris Smith to Understand Situational Decision Making
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Overview of Teaching Strategy
Older adults are among the nurse's most complex clients. They represent a broad spectrum of strengths, needs, and expectations. Yet, nurses find themselves wondering if the care decisions they make produce the best outcomes for this population. This teaching strategy will use a monologue of a nurse who provided care for older adult, Doris, to address the need for effective situational decision making. This teaching strategy can be utilized in a variety of teaching/learning situations: didactic lectures; clinical settings such as post- clinical conference/debriefings; simulation scenario debriefings; or small seminar discussions. In addition, the teaching strategy can be used with practicing nurses as a professional development activity, as well as when orienting new graduate nurses.
The student/nurse will:
- Assess the older adult’s individualized pattern and functional status using standardized assessment tools.
- Describe the complexities involved in making care decisions for older adults.
- Discuss the importance of situational decision making based on an assessment of the client when caring for older adults.
- Discuss the importance and strategies for weighing risks versus benefits when caring for older adults.
- Develop an understanding of integrating the RN’s concerns with ethics, policy, and judgment while respecting the older adult’s strengths, wishes and expectations.
Essential Knowledge Domains
- Individualized Aging
- Complexity of Care
- Vulnerability During Transitions
ACES Essential Nursing Actions
- Assess Function and Expectations
- Coordination and Management of Care
- Use Evolving Knowledge
- Make Situational Decisions
NLN Education Competencies
- Human Flourishing
- Spirit of Inquiry
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