Donna Frost

Chapter 7 232 The BP being so difficult to maintain during theatre has given Ms M quite a shock. I suggested we keep a closer eye on it for the first while. Her BP has remained stable and Ms M is feeling safe and becoming more confident in her body’s ability to recover Looking back on the encounter Jane felt that had she drawn attention to the holistic aspects of care and included them in the handover, then she would have demonstrated that she, at least, took them seriously. Moreover, she would have given her colleague a chance to do so as well. In the second situation, Jane shared during a CCCI meeting her preparations to speak at a management team meeting to ask them to consider the introduction of a proposed policy change from another angle. The topic was the time allocated to initial admission appointmentswith new residents. A lot of the admission information was pre-collected by administrative personal and available to the nurse in the electronic system and on paper before the admission appointment began. One of the goals of the pre-admission procedure was to save time for nurses so that they could complete the admission conversation more quickly. It had become apparent that this time saving was often not realized in practice and the management team had chosen this issue to focus on in the coming weeks, hoping that they could encourage the nurses to make efficiency gains. During the RNI CCCI meeting Jane was able to state very clearly her intentions during such an admission interview. She made clear that for her the conversation really had very little to do with checking medical history collecting technical information and running through the previously collected information to check for errors. Her intention during the first conversation with a new resident was to lay the groundwork for a supportive relationship, to enter his world a little, to find out what was important to him, what is concerns were at that time, to help him begin to find his feet and to experience a feeling of safety and that he was being taken seriously. She said: Running through a checklist is the last thing on my mind at that moment! It was a wake-up call to me when I realized that our management team had such a different vision about the purpose and meaning of the first real contact moment between a new resident and the nurse on the unit. (Jane-RNI-Mtg 8 -Rec 1 of 4 -p 13 ) When reflecting on this case Jane mentioned that before participation in the CCCI shewas not even aware ofwhat her own purposewaswithin the admission interview. She would have previously emphasized the more technical aspects such as taking base line measurements and checking medications. She laughed to notice how