[Sharon]

Reflect on your work experience and environment. Thinking of the research you just read on teamwork which is 10 years old now and reflecting on your work experience and environment; identify and post recommendations that have been implemented. Have they been successful?

[Melanie]

I will base this post on my experience working in Alberta as an LPN in the IVF clinic environment.

Recommendations that were made during my time there were to allow LPN’s to initiate IV’s. This was implemented by having the LPN’s complete the IV Initiation/Venipuncture course. The hospital where the clinic was situated provided us with the training and hands on practice hours all at no cost to us in order to obtain our certification.

Another recommendation was Non Stress Test (NST) for fetal heart monitoring during pregnancy. This was also implemented to allow LPN’s to perform this. Again, the hospital where the clinic was situated, offered us hands on specialized perinatal nursing education, in order to obtain our fetal monitoring certification.

These recommendations were both implemented and successful.

[Marion Catherine]

It is very difficult to respond to this question as I have less than 2 years nursing experience. What I can contribute to this conversation is that I am willing to learn and co-operate with the facility’s policy and nursing framework. In saying that, I am responsible to address areas where I am not knowledgeable or feel safe completing a particular task. Support has always been provided.
As far as provided recommendations, at this time I cannot think of anything useful.

[Alexandra]

In my current role as an RPN at the family doctors office we have initiated over the 16 years I have worked here many tasks that both the RN’s and RPN’s have been trained by other staff members (MD’s/NP’s/PA’s) such as ear syringing, strep throat swabs/process, UTI assessments, and assisting in minor procedures such as lesion removals, skin biopsies, IUD insertions, Nexplanon insertions, endometrial biopsies. WE do not perform the procedures but we do get everything ready for the MD’s and will assist in handing them the correct instruments/tools needed to complete the task and we do the clean up and processing on the biopsies bu getting the requisitions ready and sending out the sample to be tested.
When I first started working at the clinic in 2009 we did not do any of these tasks and over the years we have been taught them by the delegated staff and have to get the observation and approval of at least three different staff members before no longer requiring observation.
This was the exact same training for both RN’s and RPN’s.
I believe this has worked well for our office as the nurses have been doing these tasks for a number of years now and have built a lot of confidence in being able to perform the tasks required without concern and the support of the MD’s/NP and PA we have on staff for if we do feel we need help or more input about a more complex case.

[Marion Catherine]

Hi Alexandra, although I am unable to speak to the evolution of the role and training needs related to that evolution, my comments may seem naive. However, in the time that I have been practicing as an RPN, I have to admit that the extent of the training received when in school, particularly in lab work did not prepare me for on the job expectations. Fortunately, there were experienced RPN’s and RN’s available to support my learning and my practice so that I could practice safely.

[Sadie]

Reflecting on my work experience, the main setting where I worked closely with RPNs was long-term care, which was a number of years ago. I worked in long-term care as both a PSW and later as an RN.

In that setting, I saw many of the recommendations from the research reflected in practice, especially clear role expectations, collaboration, and good communication between team members. The roles of PSWs, RPNs, and RNs were generally well understood, and there was a clear process for when to seek support. However, I am not sure if this reflects successful implementation of the recommendations, or if it was more related to the structure of that specific practice environment.

[Author]

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