Reflective Journal Week 16

Risk Management!  Last Week and I graduate with my bachelor’s on May 3rd!!! WOOT WOOT!!  Lots of hard work but totally worth it!

1. What did you actually learned from the unit. 

I learned about the law that was put into effect that made it so a healthcare provider can say sorry without it being counted against them in court for an admission of guilt.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

There was only a discussion this last week and we are all on the same page.  In the scenario the nurse did her best and followed procedure and protocol, except with one of the 15 min checks but that was because another pt. was having serious issues.  We agreed that protocol needs to be changed for less patients or even 1:1 status when a pt. is in restraints. 

3. How you will utilize the information learned in your nursing practice.

I think one of the things I have learned from this class is to question if the protocol is safe?  Question and understand your leaders and be yourself a leader on the unit.  It’s okay to notice that something is not a safe practice and then push for a change.

4. You personal feelings about the material covered.

I think anyone in a restraint should be a 1:1 patient.  Too many things could go wrong in a 15 min break.  I also thought it was interesting to here the lecture and how much risk management is on your team as a nurse.  I had thought in the past that we were kind of on our own in that situation but she spoke more like she was on there for the nurse or doctor.  That was nice to hear.

Reflective Journal Week 15

Reflection on collective bargaining and motivating employees.

1. What did you actually learned from the unit.

I learned that my employers and smart when it comes to motivating me:) At my work they do wow cards, movie tickets, lunches on busy days, bday/anniversary gifts, and personalized notes. I think the collective bargaining unit was interesting!

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

I have always had a negative thoughts about union but the collective bargaining exercise showed me that there are benefits to having a union.

3. How you will utilize the information learned in your nursing practice.

I think I will pay more attention to giving positive motivation and encouragement to my fellow employees!

4. You personal feelings about the material covered.

I enjoyed the motivation ideas and think that a work environment that involves positive reinforcement as well as team building is a much happier place to work. I liked how in the scenario it was a work environment where the pay was good but the employees were unhappy. It was about turning the environment around into a place that we would all want to work.

Reflective Journal Week 14

1. What did you actually learned from the unit.

         Conflict is going to happen, but is not always a bad thing.  We can use conflict to understand the complexities of an issue and grow as a team in understanding and cooperation.


2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

I enjoyed the discussion, it was great to look at other examples of personal and professional conflict in my team members discussion.  We all ere in general agreement in the discussion.

3. How you will utilize the information learned in your nursing practice.

Honestly I hope to incorporate “Active listening” into my personal and professional life.  I am a talker and love to express my stories and my own advice.  Sometimes I find myself thinking about what I’m going to say next instead of listening to the person who is talking with me.  I really want to improve in this way.

4. You personal feelings about the material covered.

I think I am very good at avoiding conflict, which in some ways is a good quality.  But I think it is important to recognize when it is not appropriate to be a “peace maker” especially when it involves safety or quality of care.  It was interesting to me to see how conflict can bring a team closer together through understanding of each other and cooperation.   

Journal Child Week 14

Child Journal

The article I was assigned to read: Child abuse: Recognizing the injuries. I was surprised to learn a lot from the article and the case studies within the article. One of the things that was alarming was that the “first recorded legal action to protect a child from abuse was initiated by the American Society for the Prevention of Cruelty to Animals.” (Sunderland, 2002). It seems a sad history that animals were protected before children. I learned more about the signs and symptoms for: Physical abuse, sexual abuse, Imposed illness, and also the symptoms of the abuse but cases where it is actually an infection or a person lying for attention/money.
Currency: The article was written in 2002 but is still applicable to today. Relevance: The article remained relevant to child abuse and the different case studies supported the material. Authority: The author is a doctor at The Birmingham Children’s Hospital on the Orthopedic and Burns Unit. Accuracy: The article looks accurate and has good credible sources. Purpose: The author stays true to his purpose and gives information about child abuse and recognizing injuries that would imply child abuse or not.

Week 13 Leadership

1. What did you actually learn from the unit.

Planning, strategy, objectives, and goals are a crucial part to keeping ahead of the curve in business.  I applied a lot of these lessons to my personal life and feel that these ideas could be used to help you succeed in your personal life as well.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

This week we had a team discussion on what MSN program UVU should provide for their students and why.  We all agreed that a NP program would be the most competitive and that it would have high enrollment and interest.  

3. How you will utilize the information learned in your nursing practice.

I liked how in the lecture you discussed aligning yourself with a company and it’s values and goals.  You asked what would be a “deal breaker” for me personally.  The truth is if I was asked to participate in an abortion I would actually quit, that for me is murder I won’t participate in murder.  

4. You personal feelings about the material covered.

This course has been eye opening to me in all the complexities of leadership and healthcare.  It has helped me understand my manager, charge nurses, and other upper management positions and the stress and complexity of their jobs.  This specific week was very interesting and felt like the process of eating an elephant one bite at a time.  Each step building upon the other until the goal and objective is achieved.   


Journal of Musculoskeletal Conditions

Journal Musculoskeletal Conditions

The article that I was asked to reflect on is: The effect of a Long-Term, community-Based Exercise Program on Bone Mineral Density in Postmenopausal Women with Pre-Diabetes and Type 2 Diabetes. The used a training group and a control and did a 32-week communist-based exercise program on bone mineral density and body composition. They randomly assigned 10 women for the community-based multicomponent training and 10 to the control group. In this study it was concluded that multicomponent training is effect at preventing osteoporosis and sarcopenia among postmenopausal women with pre-diabetes and Type 2 diabetes.

Currency: The article was published in 2014 so is fairly current. Relevance: The article remained relevant to the study. Authority: Authors do have authority to write the article as they are a part of the Department of Physical Education at the Federal University of Piaui in Brazil. Accuracy: The information, study, and sources look accuracy. The control group of 10 and a study group of 10 is a very small group to test and may put some of the results into question. Purpose: The purpose was to show the benefit of exercise for postmenopausal women with pre-diabetes and type 2 diabetes, they succeeded in showing the benefit. It was based on fact and not opinion.

Reflective Journal: Leadership Week 12

Reflect on the unit topic. Type the following in your Reflective Journal/Blog.

1. What did you actually learned from the unit.

Surprisingly I learned a lot about other people in my group during this week.  They shared personal experiences of change and learning to adapt.  I also read the “Who moved my Cheese.”  story and found it very interesting and applicable to my life and others around me.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

I enjoyed the discussion on which character we felt we were from the story.  Breezy was the only one who didn’t choose Haw!  I work with Breezy and have to agree that she is more like sniff and Scurry.  She is great with change and is always ready to implement the next project!  

3. How you will utilize the information learned in your nursing practice.

As a nurse you have to get used to change!  Healthcare is going to continue to change, develop, and hopefully improve.  Don’t be the person to slow these improvements down.  Be apart of the solution not the problem.

4. You personal feelings about the material covered.

I hated change as a child, adolescent, young adult, and even until I was I’m my twenties.  I lived in the same house from birth until I got married.  Every new change was so hard form me to adapt to.  Getting married, having my first child, moving to different homes, traveling, etc…  My husband on the other hand had moved a lot as a child, went on a mission, lived away from home for a couple years, he gets easily bored if there is not a new “change” on the horizon.  I’m glad that I had to go through these experiences and have learned to adapt to change.  I don’t even know who that person was sixteen years ago.  If I could travel to a new location for every vacation, I would!  I love new experiences and I find that I can adapt to change a lot better than I used to.  Here’s to continually improving on my ability to adapt:)  

Budget Interview: Sonja Boyer

Budget Interview
Sonja Boyer
Wood Side Homes

1.What steps do you take in the budgetary process in terms of developing, implementing, and evaluating your plan?

Building the budget I do estimates off of experience and history. After we get closer we narrow down scope as we understand more. Guesstimate to an estimate. We then have two or three parties bidding on the job. For these bids we finalize a final budget. We use this budget for 18 months as a reference. We do budget by phases in construction. We end a finalize payment on each phase and them open the next phase. Whatever the original budget was we put a 10-15% continence to pull from for variances.

2.Can you tell me more about the costs of your organization: fixed, variable, direct, indirect, controllable, and noncontrollable?

In mine it is fixed, with an estimate and we accept it is what it is for 2 to 3 years. I have watched in purchasing, you bid on a community and it won’t start for 6 months and then it goes for 3-4 years. There is a every other year window for agreed upon contract to be adjusted for inflation. If there is not a way for our subs not to make money or lose their business because of a huge job in lumber or other commodity, then we have a conversation to fix the problem.

3.What do you do when there is inconsistency between the approved budget and the actual expenditure of a department?

I would call them up and say, “hey, walk me through whats changed?” If they can justify the change than we use contingency fund, if we can’t justify then they cut their price to original bid.

4 Do you have to oversee several different department budgets? If so how do you prioritize your time between each department.

Yes! I do oversee several different budgets. The company tries to create an even work flow. Where communities can come on line in a certain order, this provides an even work flow. On one community I’m waiting for guesstimates, or estimates, or awarding contracts.

5 Have you been a part of a large budget cut? How did you implement that?

Yes, during the downturn we were trying to find ways to cut budgets. Home sales became low, and amount of people who could afford became low. So we revamped our floor plans for more value oriented. Before downturn big open spaces with gingerbread trim. After the crash the only homes that would sale were smaller square feet and less show so we moved to match the market.

6 What is the most challenging part of  budgeting?

Probably, two things, communication and desire to provide more. I love to have beautiful design, usually beautiful design is a higher price tag. So I have to prioritize design that matches the project. Bigger project you get more model homes, landscape, and design. You need to create to get more foot traffic. Smaller community less budget and narrow down necessities with in good design. Communication-you have to understand all the parties involved, development agreement, internal team rules, City government, and HOA agreements.

7  When you have a big expense once a year, do you allocate it across twelve months?  Or do you add it to that month’s budget only?

If there is a big expense that spans multiple communities. Say for example if, I rented out a space for an office space for the month. Every community will pay for that expense. As they open up the expense is spread throughout the communities.

8  When you have a variable amount for an item in your budget how do you handle it?  Do you take the mean?  Or just the highest possible amount for the item?

I would put the highest amount in the budget.

9  Do you use a zero based budget or do you use last years numbers as a basis so you can increase or decrease the numbers from there?

I take a guesstimate from past numbers and the guesstimate will get you through planning and then I get it all bidded out and then they become estimates that are awarded.

10  Do you give budgeted salary increases based on a percentage for everyone?  Or do you give performance raises, and do you budget for those raises?

I don’t handle that but I can tell you how the company handles it. We are salaried employees that are based on performance as well as bonuses that are based on performance.

11 Who is involved in evaluating/implementing changes to the budget?

Myself and the land manager, when we do land acquisition, he puts together a guesstimate budget, and then there is a lot more contingency in his budget. That budget will come to me and I decide if it will work. All of my budgets get adjusted depending on land acquisition.

12  Do employees have access to the budget? Is the budget transparent to everyone in the department?

The budget is transparent to our department, the president and the controller.

This was a very interesting interview to do with my sister. She is a fun, happy, spontaneous, and organized person and to see and hear her in her work environment was super cool. She is such a core part of the company. My father is a retired contractor and it was one business I seriously considered going into before becoming a nurse. This conversation made me even happier that I chose nursing even though construction is interesting. Like I said before, I hate accounting and budgets, even though I understand the crucial importance of having a budget and holding to the budget I’m glad I’m not in charge of it.

Journal-Abdominal Conditions

Journal-Abdominal Conditions
Michelle C. Ballard

The article that was assigned to read was titled, “Analysis of the Benefits and Costs of a National Campaign to Promote Colorectal Cancer Screening: CDC’s Screen for Life—National colorectal Cancer Action Campaign.” I found it very interesting that the study found that Screen for Life: National Colorectal Cancer Action Campaign (SFL) to be effective on informing the public on the need for colorectal cancer screenings (CCS). As well that the SFL is estimated at increasing the percentage of the population over age fifty to go in and get screened. This campaign is also very cost effect at only costing on average $2.44 per person. The article goes on to say why they can only estimate because of the limited amount of data measuring outcomes and state the importance of providing more data, and outcome measures when doing any type of healthcare campaign in the future so that we are able to measure it’s effectiveness.
Currency: The article was published in 2014. It is still very applicable because it is only four years old and CCS are still very important. Relevance: The article was very relevant to it’s title and appcomalished the goal and study presented by the authors. Authority: Most of the authors are PhDs as well as the study was funded by the Centers for Disease Control and Prevention. Accuracy: The sources and information appears accurate and try. There are no speeling, grammar, or other typographical errors noted. Purpose: The article did accomplish its purpose. The information was presented factually and did not seem to be swayed by opinion or propaganda. No biases were noted.

Nursing Leadership: Week 10

1. What did you actually learned from the unit.

I learned about the different types of staffing of nursing units and the pros and cons to each.  I also learned more in-depth about the many different opportunities to nurses in continuing education and employment.  

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

The staffing assignment was surprisingly complex.  I have always said that doing the schedule is a thankless job and I stand behind that statement!  It’s hard to get everyone staffed with good shifts while keeping complete coverage of a floor.  It was also hard because some nurses prefer to cluster shifts while other hate to work more than two in a row.  I prefer to cluster, so that is how I built the part of the schedule I worked on, as there was no mention of preferences of employees I just did what I would prefer. 

3. How you will utilize the information learned in your nursing practice.

I have always given the scheduler on our unit the benefit of the doubt.  That she is doing the best she can.  If I need something changed I can usually find another employee to trade with.  I will continue to just appreciate the time the scheduler puts into organizing the schedule.  As we move into self scheduling I know the scheduler has to go through and make necessary changes to the schedule and I don’t envy her in this responsibility.

4. You personal feelings about the material covered.

I think the budget and scheduling would be my least liked job in nursing!  I am a people person and don’t like handling the details.  That being said I can be very organized and do the jobs if needed BUT I don’t enjoy that type of work.  Glad that it is a limited part of my job right now.