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As a nurse working on the Vascular Access Team we take care of patients requiring access for long term antibiotics at home or intravenous nutrition or medications and blood draws. We place PICC (Peripheral Inserted Central Catheter) lines and midlines, care for patients with mediports by accessing the port on admission and deaccesssing on discharge and caring for them during their hospital stay and caring for patients with central lines. We collaborate with the patient, patient’s family, primary nurse, medical team, nurse practitioner, physician assistant, case manager and other interprofessional teams to provide the highest standard of care and achieve the best possible outcomes. Providing care based on Compassion, Advocacy, Resilience and Evidence-Based Practice will improve patient care along with effective communication skills and collaboration with other interprofessional teams will enhance patient care and achieve possible outcomes. One of the areas we can improve is in our attitude to work, having a more positive voice when speaking to other healthcare professionals remembering it’s not what you say but the way that you say it, we should assist the floor nurses in reaching the best possible outcomes by utilizing our skills if a patient has poor access and the nurse is struggling to place IVL, we certainly can assist in the continuity of care.
A compassionate nurse has empathy towards the patients for the pain and suffering they are experiencing which is vital to the patient’s well-being. Compassionate care is one of many actions taking by nurses to improve patient’s outcomes whether they are in pain or suffering from mental or emotional stress. The patient has more confidence in a nurse who provides compassion. On the Vascular Access Team (VAT) we demonstrate compassion by forming a relationship with the patient and their family members at the first time we meet the patient at the Introduction, we actively listen to all concerns and answer all questions asked to the best of our ability and if we do not have the answer we reach out to the necessary personal or interprofesionsal teams to find the answer and to address the patients concerns. At each shift, we implement a compassionate culture by listening to each other, effectively communicating and by respecting each other. When we place a PICC line there are two staff nurses from the VAT team one is placing the PICC line and the other an observer, the role of the observer nurse is to emotional support, be an active listener, help relieve patient concern, using a positive voice and body language, been there to show empathy and provide touch by holding a hand if patient is experiencing pain or discomfort during the procedure. We the team always ask the patient is there anything we can do for you before we leave? And ensure the nurse call bell is in arm reach if the patient needs assistance. We provide education during the procedure for the care required of the Picc line at home and a booklet is also provided with the information needed.
A nurse advocate works on behalf of the patient to maintain quality of care. Advocacy is a necessity. On our VAT team safety is our priority. According to Levy (2018), in order for advocacy to be effective, nurses must maintain ethical awareness, self-confidence, persistence, pride in the profession and maturity. On our team, we ensure the patients voices are heard and they fully understand the reasoning for the Picc line in regards to their treatment. We work in collaboration with many interprofessional teams, Physicians, Physician Assistants, Nurse Practitioners, floor nurses, Case Managers and radiologists and the Intervention Radiology Team. We as nurses are engaged. Influence involves advocacy, we influence each other. We collaborate with our nurse manager at a monthly meeting and here we voice our concerns. Advocacy ensures quality care is given and the safety of the patients and environment is maintained at all times. We work with the Interprofessional teams and all have the same goal to achieve the best possible outcome for the patient and improve patient satisfaction.
Resilience helps nurses to deal with a stressful healthcare environment and to minimize stress that causes burnout and emotional exhaustion. A nurse’s role is complex, requiring continuous education or learning. Resilience to change causes a lot of stress. On our VAT team in December 2017 cut backs were made and three nurses were placed in different departments, it caused stress as the workload increased and the nurses on our team are nearly at retirement age and very resistant to the changes been made at the time. They struggled to adapt. The IV team was no longer in existence we were now called VAT team, continuously been paged for IVL’s was stressful and having to refuse to place IVL was disheartening. Floors consistently paging for IVLs certainly affected the rate we were able to get our other work completed as in placing Picc lines and taking care of all central line procedures from changing dressings to accessing and deaccessing ports. Due to not having an IV team the request for midlines drastically increased due to change in policy for IVL’s. Emotional support and strategies to enhance resilience was provided by our managers. We helped each other. The interprofessional teams also had to be educated on the change. Teams must work together to reduce stress. Resilience can have a positive outcome if staff are prepared to deal with the change and taking care of personal health and well-being. The organization also made a policy change that benefited patient’s outcomes. A midline now can be placed by one nurse replacing two nurses having to place midlines this has reduced the wait time for patients to receive treatments and medications and patients to be discharged.
Within our team, Evidence Based Practice (EBP) has been used. Change has to occur for EBP to be effective. It will improve and change ways in which we practice to have better outcomes, enhance patient care and promote patient safety. The care and compassion provided by the VAT team eliminates fear and provides for the patient to trust and respect the nurse. Effective communication skills with interprofessional teams has proven to be effective. This improves patient’s outcomes which has been evident in patient’s surveys as in HCAHPS survey.
Using the iCARE model in nursing and collaboration within the interdisciplinary team is important along with compassion, advocacy, resilience and founded on evidence based practice to provide high quality care and to provide best possible outcomes for the patient’s and patient’s safety. The nurses are in the front line leading the interprofessional teams as nurses we form relationships with patients and their families and are there advocates during hospital admission. Transition in care from hospital to home or any rehab facility can be achieved by utilizing the components of the iCARE model and collaborating with the interprofessional teams effectively. References
- Levy, N. B. L. (2018). Legal Issues…Patient Advocacy and the Nursing Role. CINAHL Nursing Guide. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=T707493&site
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