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Damion Jenkins MSN, RN

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Hi! I am Damion - an NCLEX Prep Expert Tutor and Writer! I am the owner and operator of TheNurseSpeak.com.

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Damion Jenkins has 10 years experience as a MSN, RN and specializes in NCLEX Prep Expert - 100% Pass Rate!.

Hi! I am Damion - an NCLEX Prep Expert Tutor and Writer! I am the owner and operator of TheNurseSpeak.com. - a nursing education and consulting company & blog.

Did you know that over 20% of new grad nurses fail the NCLEX?!? -I help to increase the number of nurses entering the profession by helping them develop strategies for NCLEX success!

To learn more, please visit thenursespeak.com or message me so we can discuss how I can help you become a licensed nurse!

Damion Jenkins's Latest Activity

  1. In part one of this three part series, we discussed: The Nursing Code of Ethics Ethical challenges in Nursing In this part two, we will identify some collaborative and innovative solutions to improve ethical nursing practice. Collaborative Solutions to Enhance Ethical Practice in Nursing Since the dawn of modern nursing, nurses have borne the brunt of trauma, despair, grief, loss and patient suffering. They are faced with monumental ethical dilemmas on a daily basis because they are always on the frontlines in the delivery of patient care, healthcare inequities, patient trauma, grief, and loss. No matter what - good, bad, or ugly - nurses are always there on the frontlines. As nurses fight to improve workplace conditions, seek legislation to support safe staffing ratios, and pull up a seat at the table as a valuable stakeholder, all while dealing with the daily grind of just being a nurse - it is no surprise that high staff turnover, job dissatisfaction and burnout among nurses is common within healthcare settings. The truth is that nurses can only recharge their compassion batteries so many times without additional support from outside energy sources . After a while, the nurse's batteries will drain and the nurse will be forced to find another energy source elsewhere. If they are not supported and allowed to recharge appropriately, nurses will continue to leave jobs, be dissatisfied, and experience burnout. As a result, it is crucial that nurses are supported by their leadership and administration during times of ethical dilemma and moral distress. Healthy workplace experts and nursing ethics committees have made several suggestions for daily system, educational, and operational changes that leadership can adopt to help address ethical challenges, increase nursing resilience, and improve nursing ethical wellbeing - which ultimately improves employee retention and job satisfaction. Here are the latest suggestions for collaborative and innovative solutions: Improve processes to promote mental and physiological well-being of nurses, such as nutritional, physical and mental health services that are free of charge for employees Develop initiatives to empower and enable nurses to speak up during times of ethical dilemma and moral distress Create unit-based interventional programs aiming to enhance the quality of communication among colleagues and other members of the healthcare team Implement multidisciplinary rounds to address ethical considerations and dilemmas, as well as support one another in their coping, grief and mental health Teach effective coping strategies towards work-related stress and assertiveness attitudes Promote ethical dilemma and moral distress education for all healthcare staff Provide counseling services for all healthcare staff (especially nurses) who are facing ethical dilemma, moral distress, and/or PTSD from work-related traumas and loss Transparency of action plans to address ethical dilemmas in nursing from nursing leadership and facility administration Incorporate collaborative interdisciplinary workplace safety initiatives that focus on best practices to manage violence at all levels. Implement holistic resilience programs, such as supporting wellness, secured meal breaks, access to filtered water, healthy snacks, relaxation modalities, and extended grief leave benefits to reduce workplace related stress and PTSD Complex, Holistic & Rewarding These complex interventions are not easy to establish into everyday practice and will take a lot of interdisciplinary effort, However, once these practices are in place, healthcare facilities will see happier, healthier and more resilient nursing teams. Stay tuned for part three, where we will discuss how to identify barriers to providing ethical care and disucss some Nurse-driven ethical practice improvement initiatives. Best Wishes, Damion
  2. Firstly, I would like to say that the most trusted place to find up-to-date information about the NCLEX is directly from the source - the NCSBN website - NCSBN.org. You can find everything about the exam by visiting their website. The NCSBN has created a special page that is devoted to providing updates regarding COVID-19 and its impact on NCLEX test-takers. That URL is listed in the references section of this article. To help make it easier for you to understand, I have pulled out the most important facts you’ll need to know: Computerized Adaptive Testing (CAT) will still be used The minimum number of test items will be 60 The maximum number of test items will be 130 The maximum testing time will be 4 hours The difficulty level and passing standard has not changed The Next Generation NCLEX Special Research Section will NOT be included The above changes apply to both the RN and PN exams These changes have been implemented as a means to ensure all testing centers can maintain optimal social distancing measures, increase disinfection and cleaning processes, and enhance the safety of test-takers as well as testing center personnel. Additionally, these terms were also part of the negotiations between Pearson Vue, the NCSBN, States Boards of Nursing and Local Government Agencies. These negotiations were made in an effort to prevent the closure of all testing centers during an international health emergency. The unfortunate reality is that not all of the Local Government Agencies agreed to allowing testing centers to remain open, and thus many NCLEX candidates had their testing dates cancelled, and now have to wait a much longer than anticipated time to test. The good news though is that it appears that the expiration date to test has been extended extensively (some up to a year) so hopefully this will help many plan accordingly as all of our priorities shift to care for ourselves, our families and our communities. If you or someone you know is facing a much longer wait time to test, I recommend that you take the extended time to really focus on creating a killer study plan! Here are some simple, yet practical tips to gear up and prepare yourself for NCLEX success: Create a study schedule Learn as much as you can about the NCLEX design, structure and content Develop a study plan Review content and practice NCLEX questions Identify areas of weakness and plan time to review that content more closely Find a study partner or professional tutor to help guide you and hold you accountable Focus on test-taking strategies and really learn how to answer NCLEX questions Be sure to limit your study time to 3 or 4 hours per day so you have balance Make time each day to relax, exercise, and enjoy time with friends and family Complete readiness predictor tests to gauge your performance Focus on a limited number of NCLEX Prep resources - too many can overwhelm you and even have conflicting information Be sure you know how to navigate to the testing center at least the day before the exam Do not study content the day of the exam - you should be rested and have a clear mind going into the test I hope you find this information helpful during these uncertain times, and I hope that you have all the success on the NCLEX and within the nursing profession! References NCSBN Extends Modified NCLEX Through Sept.30, 2020
  3. In this three-part series, we will discuss The Nursing Code of Ethics Ethical challenges in Nursing Collaborative solutions to improve upon ethical challenges Innovative ways to improve ethical practice in healthcare How to identify barriers to providing ethical care and Nurse-driven quality improvement initiatives In part one of this three-part series, let’s review the nursing code of ethics and explore some common ethical challenges in nursing: THE NURSING CODE OF ETHICS Florence Nightingale believed that a nurse’s ethical duty was first and foremost to care for the patient. This belief underpins every discussion of ethics in nursing to date. As health care becomes increasingly complex and the variety of circumstances nurses face becomes more challenging, considerable elaboration on ethical principles is required. There are four core concepts which are essential to professional nursing practice. They are – respect for patient autonomy, and the duty to act with beneficence, nonmaleficence and justice. The American Nurses Association (ANA) adopted its first formal code of ethics in 1950. Over the years, many of the specifics have evolved and been clarified, yet the essentials remain. (The International Council of Nurses (ICN) also has had a Code of Ethics for Nurses since 1953.) The Code has since been through two thoughtful and lengthy revision processes, which included seeking input from nursing leaders and staff nurses alike, and developing examples of how the new Code could be used in specific clinical situations. The most recent revised document, known as the Code of Ethics for Nurses With Interpretive Statements, gained final organizational approval in January 2015. According to ANA, the Code “is foundational to nursing theory, practice, and praxis in its expression of the values, virtues, and obligations that shape, guide, and inform nursing as a profession,” and it serves the following purposes: It is a succinct statement of the ethical values, obligations, duties, and professional ideals of nurses individually and collectively. It is the profession’s non-negotiable ethical standard. It is an expression of nursing’s own understanding of its commitment to society. ETHICAL CONSIDERATIONS IN NURSING PRACTICE The ANA Code of Ethics has nine provisions that encompasses the role of the professional nurse in its entirety. The nine provisions include: Provision 1 The nurse in all professional relationships, practices compassion and respect for the dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. This provision includes subconcepts that include: Respect for human dignity Relationships to patients The nature of health problems The right to self-determination Relationships with colleagues and others Provision 2 The nurse’s primary commitment is to the patient, whether an individual, family, group or community. This provision includes subconcepts that include: Primacy of the patient’s interests Conflict of interest for nurses Collaboration Professional boundaries Provision 3 The nurse promotes, advocates for, and strives to protect the health, safety, and rights of patient. This provision includes subconcepts that include: Right to privacy Right to confidentiality Protection of participants in research Standards and review mechanisms Acting on questionable practice Addressing impaired practice Provision 4 The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimal patient care. This provision includes subconcepts that include: Acceptance of accountability and responsibility Accountability for nursing judgment and action Responsibility for nursing judgment and action Delegation of nursing activities Provision 5 The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. This provision includes subconcepts that include: Moral self-respect Professional growth and maintenance of competence Wholeness of character Preservation of integrity Provision 6 The nurse participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality healthcare and consistent with the values of the profession through individual and collective action. This provision includes subconcepts that include: Influence of the environment on moral virtues and values Influence of the environment on ethical obligations Responsibility for the healthcare environment Provision 7 The nurse participates in the advancement of the nursing profession through contributions to practice, education, administration and knowledge development. This provision includes subconcepts that include: Advancing the profession through active involvement in nursing and in health care policy Advancing the profession by developing, maintaining and implementing professional standards in clinical, administrative, and educational practice Advancing the profession through knowledge development, dissemination, and application of practice Provision 8 The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs. This provision includes subconcepts that include: Health needs and concerns Responsibilities to the public Provision 9 The profession of nursing, as represented by their associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. This provision includes subconcepts that include: Assertion of values The profession carries out its collective responsibility through professional associations Intraprofessional integrity Social reform COMMON ETHICAL DILEMMAS IN NURSING PRACTICE When nurses encounter ethical dilemmas in situations in which they cannot do what they consider to be “the right thing,” they experience moral distress. Let’s take a look as some examples of common ethical dilemmas in nursing practice: Inadequate staffing ratios Maintaining safety for self and patients End of life care Genetics and gene testing Workplace bullying and lateral violence Crippling healthcare costs Unsupportive nursing administration An example of maintaining safety for self and patients includes caring for those with mobility deficits, which may place them at risk for self-harm. Let’s consider that an alert and oriented elderly patient may want to walk without any nursing or nursing assistant supervision. The nurse knows that promoting independence is a therapeutic intervention, but the risk of patient injury due to falling may be great. The dilemma then becomes – how should the nurse balance the contrasting issues? Which is more important – patient independence or patient safety? Each nurse, patient, family, and healthcare team faces challenges such as this on a daily basis. Since nurses are caregivers on the front lines of health care, we are faced with ethical dilemmas at an increasing rate. Another example is that healthcare technology enables sick people to survive serious illnesses, however recent studies indicate that people who are surviving are not living high-quality lives. In fact, they are mostly bedridden, disabled, have have extensive comorbidities that make their day-to-day health care regimens incredibly complicated. This may place nurses in ethical dilemmas due to prolonging the suffering of individuals. Regardless of where nurses fall into ethical dilemmas, we have a role in implementing educational and clinical practices which address these individual issues as they arise. NEGATIVE EFFECTS OF ETHICAL DILEMMAS ON NURSE RETENTION Since nurses face increasing ethical dilemmas within the profession, nurse retention is suffering. Bullying and lateral violence in the workplace is one of the leading reasons why nurses leave the profession altogether. While nursing leadership and hospital administration continue to diminish the topic of bullying and lateral violence, nurses are leaving the profession in droves. In fact, approximately 60% of new nurses left their first job within six months due to bullying from their coworkers. When nurses are faced with unsupportive employers who do not invest in services to help their nursing staff navigate through ethical dilemmas, their moral distress may cause them to choose to leave their current place of employment with the hopes of finding a better fit. NEGATIVE EFFECTS OF ETHICAL DILEMMAS ON PATIENT OUTCOMES Much like the effects of ethical dilemmas on nurse retention, patient outcomes are also at risk for negative impact. When nurses are distracted, torn, and struggling with moral distress due to unresolved ethical dilemmas, their focus shifts from patient-centeredness to that of self-preservation. When nurses face shifting priorities from that of the patient to themselves, patient outcomes will ultimately suffer. In a recent study, it was found that work-related moral distress may be associated with compromised health status among health professionals, reduced productivity, and inadequate safety during patient care. As you can see, ethical challenges in nursing can cause a lot of distraction – which requires immediate resolution to promote optimal conditions for patient safety. Stay tuned for part two of this three-part series, where we will go over collaborative solutions to enhance ethical practice in nursing and advocating for ethical patient care. Best Wishes, Damion
  4. Damion Jenkins

    Failed NCLEX 3 times...HELP

    Don't give up! Focus on learning ways to systematically pick apart the questions to better understand what they're asking. Here's a helpful tip: For example - If a question leaves you feeling like you don't have enough information to make a solid decision on what you should do next, the likely answer choice could be in the form of assessment. Always Assess First! If a question gives you enough information that helps you to determine what you should do next, the answer choice could be in the form of implementation. For instance what is the first thing you should do for a suspected fracture? Stabilize it! That's Implementation. There's so many different ways to skin a CAT... but the best way to do so is to be cautious and clever. Critical thinking is truly the measure of success on the NCLEX. Best of luck! -Damion
  5. Of course we will have days that bring on the normal stress of the job, however many of us may feel the struggle a bit more ourselves with being away from our families because holiday shift bidding didn’t go as planned. Even though it comes with the territory of being a nurse, it doesn’t make being away from our loved ones any easier. Therefore, it’s essential to make the best of our holiday shifts and bring our colleagues, patients and their families the warmth and joy of the season! Here are 3 easy steps to sprinkle in a bit of Holiday cheer at the bedside: STEP 1: Live in the Light of GRATITUDE Start each of your days off by giving thanks for all that you have. It’s easy to get used to all of the comforts and conveniences that we’ve worked our butts off to enjoy, but we should always be wise to give thanks for what we have that’s going right for us, rather than focusing on the negative. One easy way to do this is to consider the fact that we get to go home to our families at the end of our shifts, and that our patients in many cases cannot. We should also be grateful that we have the opportunity and capacity to provide service to our patients and their families during the holidays. Whether they say so or not, I know my services are very much appreciated and that makes me feel good. So when you’re feeling frustrated or feeling down because you are not with your family during your holiday shifts, just think about all the things you are grateful for and your spirits will sure to be lifted! STEP 2: Be Festive and Create Some FUN at Work Whether it be caroling on the unit, making holiday cards for your patients, or participating in a pot-luck lunches, be sure to join in on the festivities! We all know that organizing a pot-luck luncheon for staff in a healthcare facility can be a challenge, but when we finally get that chance to break free from patient care to grab a bite to eat – NOTHING is better than having a home cooked holiday meal! Also, be sure to involve your patients and their family members in holiday festivities as well. It’s really something special when you can take a few extra minutes out of your shift to do something so very meaningful for your patients. So instead of being a Grinch because you are stuck at work during the holidays – make sure you have a little fun by sharing in the Joy of the season! STEP 3: Spend MORE Quality Time with Your Patients and Their Families Nothing means more to a patient and their family than a nurse or nursing assistant who spends a lot of quality time with them. Patients often complain that they get to see their healthcare providers and nursing staff far less than they would like. In order to bring your patients and their families some of that Holiday Spirit, plan to spend a little more time with them. Engaging in conversation about their holiday traditions, about their family members, and even what they plan to do after they are discharged (if possible), will really help to brighten up their stay, and help to pass the time. It’s understandable that you’ll find yourself busy per the usual, but finding an extra 30 minutes or so per patient will mean the world to them! So if you find yourself working this holiday season, be sure to implement these three simple, yet effective ways to help bring holiday cheer to the bedside! Best Wishes and Happy Holidays!
  6. Since nurses are expected to be self-regulated professionals, we are legally and ethically obligated to identify and make a valid attempt to resolve all practice issues as they arise as a means to minimize potential negative impacts they may have on patients, our fellow colleagues, and daily operations. In part three of this three-part series, we will focus on how to document and evaluate to improve practice issues within our work settings. Let’s take a look at two strategies we can implement to gain a better understanding of what’s going on, so we can find the best way to resolve practice issues: Document It is important to keep personal records of all steps taken to resolve a practice issue. This ensures there is an accurate account of events and that you can use to demonstrate that you’ve met your professional obligations. It is recommended that all communication with managers and other leaders of your organization be noted in your personal communication log. Additionally, it may prove to be helpful to have any discussions or meetings followed up with a summary email. This provides all parties involved with a detailed record of what was discussed and allows for you to highlight specific details, seek further clarification after you’ve thought about it for a while, and to hold other individuals accountable for their contributions to the discussion and/or meeting. Each board of nursing offers detailed information about the legal and ethical responsibilities relating to reporting and documenting challenging situations within practice. The boards of nursing help to clarify the nurse’s legal and ethical obligation to report incompetent, unethical or impaired practice of a nurse or unethical conduct by any health professional to management, administration and/or the appropriate regulatory body. When documenting any of the above mentioned, be sure to include the following: The practice issue witnessed When the practice issue occurred (specific date and time) Exactly what happened - be sure to remain objective and factual. Describe how the issue has impacted your ability to meet Standards of Practice, Code of Ethics or organizational policies Any other relevant information A request for leadership to follow-up It is essential to note that the client chart is NOT the place to document discussions regarding a practice issue unless the practice issue had a direct impact on the client. You may also be required to document the practice issue in an incident reporting system. Be sure to know your organization’s policies regarding documentation and/or refer to your state’s board of nursing for more information regarding principles of documentation related to practice issues. Evaluate The final step of the nursing process evaluation - and now you must evaluate if the practice issue has been resolved and to determine how your actions may have impacted on the issue itself. If the practice issue was addressed with the support of others, it is important to include them in the evaluation process. Remember that you are never alone in nursing practice - it is always a team effort! Evaluation helps to ensure that the issue has been addressed and serves as a way to examine what you would do or change in the event of another practice issue. Depending on the severity of the issue, it may not be possible to resolve it immediately and this should be considered during the evaluation process. If your organization’s leadership decides that it is best for them to manage the practice issue without your involvement, it is appropriate to ask that you be informed when it has been addressed or resolved. Be aware that because of confidentiality, the leadership may not be able to provide you with detailed information about how they have resolved the issue. They may only be able to inform you that the issue has been addressed. If you see the practice issue reoccur in the future, it is important to let leadership know and follow the same process as before. You’ll find that as you move through your career, and from one facility to another, things fall between the cracks as individuals leave organizations. It is very likely that an issue that you help to resolve one year, may resurface within the next year or so. If you’ve determined that the practice issues have not been resolved, take a step back and consider why. Review the process you used by asking yourself the following: Did you clearly identify the issue? Could you define how and when client care or service was affected? Were the right people involved in the discussions and attempts to resolve the issue? Is there evidence that your leadership team took steps to address the practice issue? What could have been done differently? Once you have reviewed all of the possibilities, you’ll choose your next steps. If the practice issue persists you need to continue to take action until it is addressed. Further action could include: Request a meeting if you have not yet had a meeting with your leadership team. Meet with your direct supervisor again to determine when resolution is likely if you have already met with them and the issue persists. Consider discussing the practice issue with the next level of leadership in your organization if your direct supervisor does not provide the support needed for resolution. Continue to notify the appropriate people until the issue has been resolved. In this three-part series, we’ve discussed the six steps in resolving practice issues within nursing practice. The six steps include: Identifying Practice Issues Fully Exploring the Anticipated Effect and Outcomes of the Practice Issue(s) Identifying Resources Taking Action Documenting Evaluating Does the above list of steps sound familiar? If you guessed - The Nursing Process, you’d be correct! The Nursing Process is always the most important tool that nurses can use to resolve highly complex situations - even major practice issues. To read the first 2 parts of this series, go to: Strategies for Nursing Success: Part 1 of 3 - Identifying Practice Issues Strategies for Nursing Success: Part 2 of 3 - Identifying Resources and Taking Action to Improve Practice Issues If you have any other tips or suggestions you’d like to share regarding resolving practice issues, please feel free to leave your thoughts in the comments section below! Best, Damion
  7. Damion Jenkins

    Failed NCLEX 3 times...HELP

    Sometimes one-to-one tutoring with an Expert is much better than wasting time on a bunch of NCLEX resources. If you don't know how to study, what to study, or have an individualized tutoring plan, it can be more difficult than need be.
  8. This is FABULOUS news!!! Congratulations for kicking the NCLEX's butt!! You deserve to celebrate NURSE!!! Best, Damion
  9. Since nurses are expected to be self-regulated professionals, we are legally and ethically obligated to identify and make a valid attempt to resolve all practice issues as they arise as a means to minimize potential negative impacts they may have on patients, our fellow colleagues, and daily operations. In part two of this three-part series, we will focus on how to identify resources and take action to improve practice issues in our work settings. Let’s take a look at two strategies we can implement to gain a better understanding of what’s going on, so we can find the best way to resolve practice issues: Identify Resources Please Note: If you have not read part one of this series, please do so before continuing. For those of you who have, let’s pick up where we left off and begin to identify our resources that can help us to tackle practice issues. Since we previously discussed identifying practice issues, the next step is to seek out resources that could be helpful as we move through the problem-solving process. Many helpful resources can be internal or external to your organization, and any that has the potential to be of assistance should be considered. Here are examples of resources that you may want to consider for practice improvement: Colleagues Supervisors Mentors Other Health Professionals Human Resources Clinical Educators Practice Consultants Education Programs Professional Conferences Standards of Practice Nurse Practice Act from State Board of Nursing Professional Journals and Other Publications Agency Policies and Procedures Code of Ethics and More Although this is not a complete list of possible resources you may rely on to assist in resolving practice issues, they are some of the best options that offer a great deal of support and guidance. Take Action After you have identified the necessary resources to use in improving practice issues, a planned, well thought out approach is essential to finding resolve. When forming an action plan, the following steps should be considered: Brainstorm possible solutions to resolve the practice issues. Determine the potential positive and negative outcomes for each solution identified. Decide which solution(s) could be the best approach. Develop a plan outlining the actions you will take and when you will implement the chosen solution(s). The actions you take will depend on the practice issue you are facing, the level of support you gain from your team, and the resources you have available to you. Whatever action you choose, it is important to let your manager know so that they are aware and can provide support if required. When discussing a practice issue with your supervisor, you should consider doing the following: Be sure to provide a clear objective and detailed description of the practice issue, and include how the issue has impacted patient care/safety, nursing practice, team relations and work environment. Structure conversations by using the standards of practice from your state’s Nurse Practice Act and Code of Ethics. These documents help to focus the conversation on the nurses’ professional responsibilities, keeping the conversation more objective. Do your best to leave personal opinions and emotions out of the discussion as these typically make problem-solving more difficult in the work setting. Offer possible solutions that could assist in resolving the issue(s). Identify what you could do to support the resolution of the practice issue(s). It is important to note that nursing supervisors, management and leadership are also busy problem solving their own practice issues, and therefore will need you to play an active role in helping them to address the issues. Be sure to follow up on any meetings with a written letter or email that stresses the importance of the finding solution to the practice issue(s). Be sure to ask for a reasonable date in which you can expect to hear back from the supervisors, managers and nursing leadership regarding moving forward with an action plan. Much like most of what we do in nursing practice, approaching nursing supervisors, managers and leadership requires a great deal of tact and professionalism. We don’t always get this right at first, but I’ve found from experience that if you are authentic, genuine and have good intentions when you are approaching management with practice issues, a strong leader will embrace your efforts to create positive change and they will help you to find solution to the practice issue in the best way they can. So far we have discussed four steps in resolving practice issues within our nursing practice: Identifying Practice Issues Fully Exploring the Anticipated Effect and Outcomes of the Practice Issue(s) Identifying Resources Taking Action Be sure to stay tuned for part three - where we will discuss the final two strategies in resolving practice issues for nursing success! Best, Damion
  10. Thank you for contributing to the discussion. When you are up for it, we would like to hear more about tips and strategies to help improve the process and spend a lot less time receiving unsolicited sarcasm and negative thinking.
  11. Since nurses are expected to be self-regulated professionals, we are legally and ethically obligated to identify and make a valid attempt to resolve all practice issues as they arise as a means to minimize potential negative impacts they may have on patients, our fellow colleagues, and daily operations. In part one of this three part series, we will focus on how to identify practice issues and how they may negatively affect our patients, as well as our ability to perform and function at an optimal level. Let’s take a look at two strategies we can implement to gain a better understanding of what’s going on, so we can find the best way to resolve a practice issue: Identifying a Practice Issue A practice issue can be defined as any issue or situation that either compromises patient care or services by placing a client at risk for harm, or one that affects a nurse’s ability to provide patient care or services that are consistent with current standards of practice. The first step in addressing a practice issue is being able to identify one. In order to determine if your issue is indeed a practice issue, one must ask the following questions: Does the issue present a risk to patients? Does the issue make it difficult to function according to current standards of practice? Does the issue conflict with your institution’s standards, guidelines, or policies? If you answered “yes” to any of the above questions, then you may have a practice issue that needs to be resolved. If you answered “no”, your issue is not likely a practice issue but still needs to be explored further and resolved if possible. Here are some examples of practice issues: Inappropriate use of social media such as discussing your patient on Facebook. A nurse from a telemetry unit being floated to the intensive care unit and is assigned a ventilated patient without appropriate support. Withholding critical information about a patient from a member of the healthcare team. Consistently working short staffed with unsafe nurse to patient ratios. Chronic workplace bullying and lateral violence. Once you have been able to properly identify a practice issue, you must then explore the issue to determine the severity of the issue so that you may prioritize resolution accordingly. Fully Exploring a Practice Issue Taking the time to fully explore a practice issue will help you to gain additional insight and develop a shared understanding among colleagues and other members of the healthcare team. A better understanding will also help to prevent a quick response that may be influenced by incomplete information, emotions, or assumptions surround the issue. Reflecting on a practice issue before reacting is a great way to look at the situation more objectively and can help you to quickly identify potential causes. Gaining your team's perspective can also provide further clarity about the issue and supports a team approach to resolving the issue. The following questions can assist you in reflecting on and exploring a practice issue in greater detail: How does this issue place patients at risk? How does this issue affect your ability to provide patient care according to current standards of care? Does this issue go against the Nursing Code of Ethics? Does this issue put a strain on your nursing oath to do not harm? How does this issue prevent you from following agency policies and procedures? Do you have the knowledge and skill to address the practice issue? Who is affected by the practice issue and what are their perspectives? Does your organizational policies, procedures, or guidelines contribute to this issue? Is this a recurring practice issue? And if so, why is it recurring? What are some of the anticipated outcomes if the issue goes unresolved? Develop a Description Once you have explored the practice issue in full, you will need to develop a description of the issue, making sure to be as objective as possible. You’ll want to include the date, time, place, people involved and full account of how the issue affects the client, your nursing practice and/or the healthcare team. Be sure to outline all contributing factors. Having this detailed description will be helpful when communicating the issue with your nursing leadership. In many cases, common contributing factors for practice issues include, but are not limited to: Inadequate Skill Mix Lack of Accountability Decreased Resources Lack of Responsibility Ineffective Communication Breaks in Standards of Practice Outdated Policies and Procedures Challenging Legal and Ethical Issues Workplace Bullying and Lateral Violence As you can see, the first two steps in resolving practice issues involve identifying the practice issue, then fully exploring the issue and the anticipated outcomes on the quality of patient care and delivery of high-quality nursing practice. Once you have completed the first two steps, you will move into utilizing available resources and taking action to find resolution. Stay tuned for part two - where we will discuss two more strategies in resolving practice issues for nursing success! Best, Damion
  12. Damion Jenkins

    This Forum is Quiet

    Hi Phyllis - I recommend that you connect with the National Nurses in Business Association. I am a member and I find it an extremely valuable resource for aspiring and current nurse entrepreneurs! I go to their annual conference each year for the past two years and I learn SO much about business strategy! Hope you find this helpful, and don't hesitate to reach out! Best, Damion
  13. Damion Jenkins

    Failed NCLEX 3 times...HELP

    Hi Dkray, First, let me say that you are NOT alone! I've helped over a hundred students and clients pass the NCLEX - some who have had up to 14 unsuccessful attempts! It's important to remember that the NCLEX is not a measure of your future success as a nurse, nor does it measure your intelligence or skill set. The NCLEX is designed to challenge your ability to critically think, and decipher the information thrown at you in a stressful setting - similar to what nurses face on the job every single day. Since the NCLEX is comprised of integrated questions that pull in several concepts per high-level question, it is easy for test-takers to choose the "distracting" answer choice rather than the correct answer choice. ATI, Kaplan and Hurst are all great resources for content review. I think what you may need is test-taking strategy tutoring. If you'd like more information, please do not hesitate to reach out. Remember this - if you can graduate nursing school, then you can pass the NCLEX! Best, Damion
  14. Damion Jenkins

    Break between graduating and taking NCLEX- RN, advise?

    Hi tmarie4, If you think you need a content review, there are several online options link Hurst, Kaplan, Remar, etc. However, I find that most nurse graduates don't need a full content review, but benefit most from individualized NCLEX test-taking strategy tutoring. There are several online tutors out there, and some (including myself) have a 100% pass rate. Good luck - you got this! -Damion
  15. Hi cicigz16! First, let me assure you that you are not alone in this! Many of my NCLEX clients have come to me feeling anxious after an unsuccessful attempt at passing the NCLEX. As an NCLEX Expert and with my 100% pass rate for two years in a row, I think I can be of assistance. Here are a couple tips to help to ease your anxieties: Focus on mastering your approach to every single question. You must approach each question the same way, every single time. The decision tree is a helpful resource if you know how to correctly apply it, however it is not the only strategy that exists in answering NCLEX style questions. You must be able to understand what the question is asking of you. (can you identify the topic?) Sometimes you cannot, and must look to the answer choices for clues. Focus on the harder, more complex, critical thinking questions that have integrated concepts - these are the ones that give you better chance at passing if you answer them correctly. Many of the test banks have a mixture of content focused questions, as well as integrated - high level questions. The high level questions should get your focus when studying. Try to reduce your stress levels. Get adequate sleep. Do not drink too much caffeine, exercise regularly, eat a healthy diet, and stay hydrated. Good luck, and don't hesitate to reach out if you need additional support! Best, Damion
  16. Damion Jenkins

    Nclex sata

    Hi bound&determined91! The answer to your question is - Yes. It is possible that all of the SATA answer choices can be correct. As an NCLEX Prep Expert, it is essential that I stay up on latest NCLEX trends and test plans. You may find it surprising to know that this is not new to the upcoming update, and has been possible since 2016. The most important thing to do when approaching SATA questions is to carefully consider each and every answer choice independently of the others. If it makes sense and goes along with what you've learned in school, then it should be considered as a correct answer choice. I hope this is helpful. Good luck! -Damion

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