Introduction
Transitioning from school to practice is one of the most important milestones in a newly graduated nurse’s life. However, most of them encounter difficulties in responding to different situations within the clinical setting, such as the intensive care unit (ICU). The journal article “Failure to Respond” strives to determine what informs the ICU nurse to go to the patient’s bedside to investigate an alarm triggered by the patient. Ideally, the article aims to examine key influences on nurses’ clinical decision-making – how quickly to respond to a given situation. Therefore, this reflective paper seeks to provide an in-depth review of the journal article and its overall implications for nursing practice and education.
Background Knowledge
The “Failure to Respond” journal article aims to show how ICU nurses respond to patients’ needs initiated through bedside alarms. Most importantly, the article investigates the factors that influence nurses’ determination regarding how quickly they need to respond to alarms (Despins, 2017). Guided by individual semi-structured interviews, the findings revealed that ICU nurses respond to alarms to “catch patient deterioration and prevent harm (Despins, 2017, p. 1).
More specifically, their decision-making process is informed by the nature of the patient risk and the desire to prioritize their patients’ needs. It, therefore, follows that the best way for graduate nurses to provide safe and high-quality care requires them to complete entry-level training and transition into practice. As explicated in the article, patient risk assessment is one of the critical components of the nurses’ roles in patient safety.
Challenges Imposed in Practice
The challenges that graduate nurses face as they transition into clinical practice, specifically in clinical decision-making, are complex. Nurses encounter competing care priorities that must be addressed and, at the same time, strive to keep their patients safe (Despins, 2017). Those working in the ICU encounter difficulties managing complicated cases and effectively responding to bedside alarms. They must develop the ability to assess different variables related to the patient’s condition.
The challenge with bedside alarms is that nurses must determine genuine alarms from false ones. According to Despins (2017), intensive care unit nurses receive as many as 187 alarms per day, with up to 80 percent being false. As explicated further in the “Failure to Respond” journal article, “when the number of false alarms is disproportionally high, individuals will most often miss signals such as those indicative patient risk” (Despins, 2017, p. 4). Another challenge for consideration is that young nurses are always under pressure to provide high-quality care, especially in stressful situations. Overall, nurses may experience anxiety and stress due to a lack of effective support or mentoring.
Literature Review
A critical literature review revealed that nurses working in the ICU are bound to face the aforementioned challenges at some point in their professional careers. This is the case because intensive care units provide care to patients suffering from severe and life-threatening diseases and complications that require close monitoring and care. Some of these complications, as observed by Shillan et al. (2019), include “ventilator-associated pneumonia, catheter-associated bloodstream infections and urinary tract infections, venous thromboembolism, delirium, myopathies, and neuropathies” (p. 10).
In other words, challenges such as those discussed above are common in ICU “because of the severity of illness of the patients and the subsequent high mortality, giving rise to regular ethical issues” (Shillan et al. (2019, p. 7). In a different study, Olaleye et al. (2022) observed that young nurses often face pressure because critical care nursing is largely complex. Nurses are constantly required to prioritize between competing options combined with multiple processes and interventions.
However, nurses can easily overcome these challenges by utilizing several evidence-based approaches. They include creating effective mentorship programs, simulation-based training, and using clinical decision-making frameworks (Sibiya et al., 2018). The strategies have proven helpful, especially to newly graduated nurses adapting to clinical practice – they help improve their competency and ability to respond timely to clinical situations such as bedside alarms.
Reflection
Therefore, a future nurse must embrace the concept of adaptability because change is an important component in the life of a professional nurse. Informed by the challenges associated with determining when and how to respond to bedside alarms, I will, from now on, pay close attention to my education and training. This will ensure I am well prepared to meet the demands of an ever-changing healthcare environment and nursing as a profession. Additionally, I will often look for mentorship opportunities to sharpen my decision-making skills.
In line with the above, I believe my practice will be affected by the current changes and the challenges of the “Failure to Respond” article. For instance, I now recognize the need to develop my critical skills to provide high-quality and safe patient care. Similarly, I will be required to look for more opportunities for learning and development, such as attending seminars and conferences and participating in simulation-based training.
As a future nurse, I must continue upholding the change efforts in practice. One way of achieving this will be by advocating for the adoption of clinical decision-making frameworks, encouraging the establishment of mentorship programs, and integrating simulation-based training. Such programs have proven effective in improving the competency of new graduate nurses transitioning to clinical practice.
Discussion /Implications /Conclusion
In conclusion, the main aim of the “Failure to Respond” journal article was to investigate what alerts the ICU nurse to attend to the patient at the bedside to investigate an alarm. More specifically, the authors explored factors that guide nurses’ decision-making process and how to differentiate genuine from false alarms. The article emphasizes the need for future nursing students to pay close attention to entry-level preparation to eschew and manage the challenges associated with their transition to practice.
As a future nurse, I must develop a clear understanding of the complex nature of nursing as a profession and the role of our education and training in managing these challenges. Besides taking my education seriously, I must attend conferences, look for mentorship opportunities, and participate in simulation-based training. By upholding the change efforts in the clinical practice environment, I will move closer to becoming a competent nurse – one more concerned with providing high-quality and safe patient care.
References
Despins, L. A. (2017). Factors influencing when intensive care unit nurses go to the bedside to investigate patient related alarms: A descriptive qualitative study. Intensive and Critical Care Nursing, 43, 101-107. Web.
Olaleye, T. T., Christianson, T. M., & Hoot, T. J. (2022). Nurse burnout and resiliency in critical care nurses: A scoping review. International Journal of Africa Nursing Sciences, 17. Web.
Shillan, D., Sterne, J. A., Champneys, A., & Gibbison, B. (2019). Use of machine learning to analyse routinely collected intensive care unit data: a systematic review. Critical care, 23, 1-11. Web.
Sibiya, M. N., Ngxongo, T. S. P., & Beepat, S. Y. (2018). The influence of peer mentoring on critical care nursing students’ learning outcomes. International Journal of Workplace Health Management, 11(3), 130-142. Web.