Curve Balls

Just when I finally got started on the development of the storyboard, I have had a curve ball thrown my way.

The Early warning observation chart was designed to allow the lower ranking nurses and hence nurses with minimal training to identify the patient who is deteriorating and to guide them as to the urgency of them notifying senior staff members of the patients vital signs.

Initially my aim was a simplistic observation chart with varying colours. It was then forced upon me to add aditional, non relevant information on the chart as the "document committee" was delighted with it and wanted it to replace all adult observation charts in the hospitals. This was done under much duresss.

I was then told that I had to develop a User Guide and a Facilitator Guide for the chart. (Surely if a chart requires this it is too complex?) Nonetheless I did this but incorporated the two into one document.

Thereafter I was told that a test was required in order for the staff members to be awarded MAP points, the equivalent of CPD points in MediClinic. This too was done.

I then had to compile a Powerpoint presentation to enable the Training and Development Consultant in the hosiptals to train all staff. Also done.

Last week the package was released to all the hospitals and a huge outcry ensued. The main objections being that the test is too difficult; that the whole process is too complex and that "it is obvious that an ICU person is pushing the project with no consideration to ward staff".

This has meant that the whole project has been shelved for the time being.

It has been a very interesting and frustrating project from which I have learnt about corporate pressures, hierarchy management and mismangement, back stabbing, personal reflection to name a few.

Initailly when I proposed this, I mentioned that a similar project in Australia took 2 years to develop and encompassed much action research and pilot studies before being properly initiated.
In addition it involved a team working on it. I started this on my own, with pressure from "head office" to complete it by June ... no pilot study although that is what I wanted. In addition, all work on this was done after hours, from home as my prime role is teaching critical care nursing.
(The reason why I resigned).

I am both dissappointed and relieved that this has occurred as it validates my intial approach to the project. I am however hoping that I will now bw allowed to scrap the test and the Facilitator Guide. I have proposed that I initiate a pilot study at one of the local hospitals as this will allow additional input from the Medical Practitioners, allow observation of what, if any, formal teaching is required and ensure that a streamlined package is lauched throughout the group.

Of note too is that this was sent to all hospitals at the end of June with minimal feedback received. Once it was due to be launched the outcry began.

I do believe that some of the critisism is valid and this too will be addressed, i.e. the test was not at the level of the ENA but rather at the level of the PN. In defence I had written it as a formative assessment using scenarios, i.e problem based with the aim being that feedback would be given to the staff member. Not a pass / fail test which is what was finally given to the hospitals.

During this excercise I have had exposure to "Leadership for change"; CPD; Assessment; Learning and teaching etc. .... very interesting!

I will continue using the idea as the e-learning activity as I am sure that it will be initiated after some tweaking ... if not, then I will have learnt from the process.

Bronwen