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ACTIVITY, REFLECTION, ANALYSIS, SYNTHESIS

ARAS

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A Project Paper Presented toThe Faculty of the Graduate School

San Pedro College, Davao City

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In Partial Fulfillment of the Requirements inPracticum on Administration in Healthcare Setting

By

Joanna Kaye B. Remolar, R.N

May 7, 2010


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INTRODUCTION

If Teaching is said to be the noblest profession, then teachers are the

noblest professionals.

According to Neeraja (2003), Nursing Education is the professional

education for the preparation of nurses to enable to them to render professional

nursing care to people of all ages, in all phases of health and illness, in a variety

of settings. If nurses are expected to be competent, efficient, and knowledgeable

in the field of clinical care, then the foundation must be strong. This foundation is

structured in the nursing schools which are projected to be credible sources of

nursing knowledge and anticipated to be able to pass that knowledge to nursing

aspirants. Not only that, but the skills of a student nurse must be honed and

settings designed to create an environment of adequate learning and exposure.

Most importantly, the attitude of the nurse must be receptive, open-minded,

flexible, quick, and humble at the same time to produce well-balanced and

disciplined nurses.

The level coordinators of the nursing department ensure that an

environment conducive to learning is given to the instructor and students, so that

transfer of knowledge is seamless. It is the coordinator who fixes all the minute

details of arranging schedules, harmonizing inter-agency relations, and

evaluating appropriately.


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This subject, Practicum on Nursing Education allows me to identify the

tasks and appreciate the necessity and efficiency of a coordinator so that the

nursing student is shaped into a competent, intelligent nurse.


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OBJECTIVES

That within my 3-day practicum, I will be able to practice as a Year-Level

Coordinator in San Pedro College.

Specifically, I will be able to:

a. make a courtesy call to the Dean of Nursing;

b. meet the level coordinators;

c. interview my preceptor about the responsibilities of a level chair;

d. observe the preceptors problem solving methods and ways of resolving

conflict;

e. identify the leadership style of the preceptor;

f. suggest possible ways of resolving commonly encountered problems;

g. observe how the preceptor relates to the students;

h. observe how the head nurse manages her clinical instructors; and

i. make a teaching plan as requested by the preceptor.


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DAY 1

May 4, 2010

OBJECTIVES:

At the end of my 8-hour shift, I will be able to:

a. make a courtesy call to the Dean of Nursing;

b. meet the level coordinators; and

c. interview my preceptor about the responsibilities of a level chair;

ACTION:

My first day started at 7:30 a.m. outside the office of Mrs. Jeannie Bibera,

the Dean of the Nursing Department for me to make a courtesy call. A little after

8 oclock, the secretary arrived and informed me that Mrs. Bibera had an

important event to attend to, and advised us to go directly to our preceptors. So I

went to the coordinators office and decided to wait for my preceptor outside. I sat

on the bench near to a group of nursing students in white uniform who were also

waiting for their level chair.

About 9 a.m., my preceptor Mrs. Loyalda T. Lazarraga arrived. I

approached her and she cordially invited me to her office. There I also met other

coordinators namely Maam Suam, Maam Cuevo, and Maam Pabitay. As I took

a seat on the soft bench in order to give her some time to prepare, a clinical


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instructor immediately approached her regarding a concern of his. I observed

that at the beginning they talked in a normal tone of voice but as their discussion

got deeper, they talked in hushed voices. After a while Mrs. Lazarraga

commented in a loud voice Nganong wala man ka nag ingun daan??. The c.i.

promptly left.

Afterwards, she called me and apologized for not being able to

accommodate me immediately. I responded that it was no problem and that I am

very thankful for her time. Then I asked about her responsibilities as a level chair.

Her first answer was that the task of a level-coordinator is multi-tasking. She told

me that her responsibilities are: make rotation schedule of 3 rd year students for

both concept and RLE; list the CIs who will be in-charge of the concept before

the schoolyear starts and present it to the Dean for approval; sign the teachers

load forms to be forwarded to the VP for academic affairs, president and dean for

signature; accommodate the sick leaves of CIs; check the test questions; and

verify excuse letters of students, among other tasks. She also showed me the

green form for the RLE overtime, clinical supervision record form, stacks of sick

leave applications, and a bigger stack of excuse slips. I commented that it

seemed to be involving lots of paperwork to which she agreed.

In addition, she is currently taking up her PhD in SPC, telling me that she

is challenged to be at par with the energy level of her younger classmates. Its

quite ironic since her admitted waterloo is writing and especially reading. But she

felt that it would be unseemly if she would be the only coordinator who did not

have a Masters degree, so she took it slowly, finishing it in 5 years. After getting


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her degree she realized that she found thesis-making interesting, so she

proceeded to her PhD.

REFLECTION:

Though dressed casually, Mrs. Loyalda T. Lazarraga exuded an air of

confidence and authority; one who was approachable, level-headed, firm, and

sure of her actions which I assume could only come from 6 years of being a

coordinator. I had never been under her direct supervision when I was student so

I was really glad of this opportunity to get to know her. While I waited outside her

office, the students near me were also waiting for other coordinators and I

reminisced that I used to be one of those students.

The moment the c.i. saw maam Lazarraga, he immediately sat down in

front of her to raise his concern. Maam appeared be calm at first but after she

learned further of the c.i.s request, she raised her voice which promptly caused

the c.i. to leave. This coincided with that Maam told me, that she was generally

amiable but very horrific when she got angry, especially when she knows that

she is right.

While Maam was explaining all the work that she had to do, I thought that

indeed, shes right: a coordinator has to be a multi-tasker. And patient, if I may

add, considering all the heaps and mounds of paperwork which seemed huge

enough to drown in.


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If that wasnt enough, taking her PhD at the same time would make multi-

tasking an understatement. Shes very lucky that her photographic memory

compensates more than enough for her admitted weakness in reading and

writing. I guess that at one point in life though one has achieved many goals, one

proceeds to higher education simply for self-fulfillment.

ANALYSIS:

Courtesy call is a very important initial step. As stated in Kellys Nursing

Leadership & Management (2008) regarding communicating with supervisors,

observing professional courtesies is an important first step. This demonstrates

respect and allows for the conversation to occur at an appropriate time and

place. Dress professionally. Arrive for the appointment on time.

Ellis (1997) describes anger as an irrational response that arises

from one of four irrational ideas: (1) that the treatment one received was awful;

(2) feeling that one cant stand having been treated so irresponsibly and unfairly;

(3) believing that one should not, must not behave as he did; and (4) because

one acted in a terrible manner, he is a terrible person. Marquis and Huston

(2006) have identified some leadership and management roles in conflict

management. The nurse assists the conflicting parties to identify techniques that

may resolve the conflict and accepts differences between the parties without

judgment or accusation. Kelly (2008) states that an open, honest, clear

communication is the key to successful conflict management. Courtesy in


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communicating is to be encouraged. This does not include interrupting, being

aggressive, or being overbearing in demeanor. Voice level should be calm and at

a normal tone. This sounds easy, but it may not always be easy to do.

Avillion (2005) states that Continuing Education is defined as a learning

activity designed to enhance an employees professional growth and

development. Qualifications for the staff development should reflect the

standards of the profession, should reflect the standards of the organization, and

minimum qualifications should be upheld impartially.

Furthermore, Avillion (2005) adds that adults are self-directed learners.

They determine what to learn and how they want to learn it. Thus, adults may

attend a mandatory program, but if they fell it is a waste of their time they

probably will not acquire much new knowledge. Adults know that their time is

valuable and expect education to be offered at times and in ways that are

convenient for them.

SYNTHESIS:

Goal Partially Met. I was able to meet the level coordinators, interview my

preceptor about the responsibilities of a level chair, but was not able to make a

courtesy call to the Dean herself.


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DAY 2

May 5, 2010

OBJECTIVES:


a. observe the preceptors problem solving methods and ways of resolving

conflict;

b. identify the leadership style of the preceptor; and

c. observe how the preceptor relates to the students.

ACTION:

Upon Maam Lazarragas arrival in the coordinators room she was

immediately bombarded with problems of students. One problem was that a

group of students had a schedule in the OR morning shift, but there was a

miscommunication of the clinical instructors schedule. Since the coordinator-in-

charge was absent, Maam Lazarraga accommodated the students by listening to

their problem. She called the cellphone of the ci who was supposedly on duty,

but because the ci answered that she had another commitment and there was no

other c.i. available, Maam Lazarraga called the head nurse of the OR of SPH to

negotiate if the students could report tomorrow instead. They were on first-name

basis and were obviously friends. The head nurse agreed, and the students

were sent home.


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I asked her how she handles students. In terms of excuse slips, she

interviews them before accepting their excuse. She narrates this one time a

student came to her with a diagnosis of Systemic Viral Infection on her medical

certificate, but when asked about her symptoms and medications, could give no

answer so that she was not excused. However, in obvious cases she is not

scrupulous anymore like cases of chickenpox and sore eyes, and grants them

excuse slips accordingly.

In terms of students complaining about their grades, she says the last

word to change or recompute the grade is on the clinical instructor/lecturer. Even

when the parents of the student seem toxic and threaten to go to the CHED,

she never exerts pressure on the c.i., and supports whatever is the decision of

the clinical instructor. She said that it would be inappropriate for her to pressure

the c.i. as it would be meddlesome of her. In defense of her c.i.s, the students

with failing grades are referred to the guidance counselor which calls the parents

for a meeting. Unfortunately, in some cases the parents maybe are too busy to

heed the call of the guidance office, so that when they come to school its too

late.

REFLECTION:

Students coming in and out of the office are not very common during

summer, and I can only imagine the time and patience-consuming flow of people

during the regular schoolyear. With the incidence of the group of students who

were not able to go on duty in the OR, I realized that sometimes a coordinator


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must accommodate even if it is not her scope, call the appropriate persons, and

make a decision fast. In the actual sense of the word, a coordinator must

coordinate. She is like a bridge which connects the school and the hospital to

achieve their goals.

With the case of excuse slips, I find it amusing that some students are

feigning sickness and think that they will not get caught. Not being able to

answer what your manifestations were when you were sick, if you were really

sick, is absurd. Im amazed that Maam still has the patience to go through the

day when she finds out that the student is just malingering.

Students complaining about their grade, I think, is a sensitive issue. It

requires the balance of being pro-student and pro-teacher at the same time. I

think that sometimes, it can be hard to say no when the student and the parent is

crying in front asking to give another chance to them just to pass. It must be an

emotionally taxing and trying time.

With these events I conclude that Maam Lazarraga employs a democratic

style of leadership because she does not force her own decision upon others nor

does she let them do whatever they want. She maintains the balance of letting

others participate in the decision-making while being in command.

ANALYSIS:

Negotiation is psychological and verbal. Part of the preparation should

have included learning about the people with whom the manager is negotiating.

There are many types of personalities, and it is necessary to negotiate with most


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of them. The negotiator must have clarity in his or her communication,

assertiveness, good listening skills and flexibility. (Marquis: 2003).

In addition, collaborating is an assertive and cooperative means of conflict

resolution that results in a win-win solution. It enhances a persons participation

in decision-making to accomplish mutual goals and therefore is the best method

to resolve conflict to achieve long-term benefits.

According to Neeraja (2003), the realization of educational goals

and objectives by the students in a given period is measured by evaluation,

which has become part and parcel of every system of education. Evaluation is an

act or process that allows one to make a valuable judgment about the desirability

or value of a measure. It includes both quantitative and qualitative. Evaluation of

the student is a continuous ongoing process, and to assess the intellectual levels

of students, cognitive tests will be performed. Marks are an outcome or

evaluation of students work in terms of the whole group, and represents

educational progress in school.

When a student has failing marks, he is referred to the Guidance

and Counseling Department. Neeraja (2003) defines Guidance as a process

through which an individual is able to solve their problems and pursue a path

suited to their abilities and aspirations. Guidance services must be an integral

part of the school organization. On the other hand, Counseling denotes giving of

advice, a specialized service of Guidance which is a helping relationship win a

setting that permits help to be given and received.


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DAY 3

May 6, 2010

OBJECTIVES:


a. suggest possible ways of resolving commonly encountered problems;

b. observe how the head nurse manages her clinical instructors; and

c. make a teaching plan as requested by the preceptor.

ACTION:

On my 3rd day of practicum, I asked my preceptor about her most and

least liked tasks as a coordinator. She thought about it and said that because of

her 6-year experience she had already gotten used to the all the tasks of a

coordinator. But one of her pet peeves is collecting and badgering her c.i.s to

submit the grades on time. She sets her deadline and she expects her c.i.s to

follow it since she still has to encode it herself and pass it to the registrar. She

admits that she really gets angry and admonishes her c.i.s when they do not

meet the deadline. As if on cue, someone from the other side of the room yelled

to no one in particular, Kinsa pa daw nay utang sa registrar dira, pamayad na

daw mo! which earned chuckles from the coordinators. Maam said that it was a

good thing her c.is had all passed their grades on time this summer. Then I


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asked how she handles instructors under her supervision who have more

seniority than her, and she says that she does not have any problem with them

and treats them with respect. In fact, its the younger c.is who seem to have a

problem of passing their grades on time.

Aware of the fact that she could talk 120 words per minute when she was

angry, she thought that she was not retaining her position as coordinator with the

replacement of three coordinators. She received one feedback which said she

should shut up her mouth once in a while, which she found offending. But it was

quite a pleasant surprise when she learned that after the secret ballot voting, she

gathered the highest votes of being retained as a coordinator, though it would

also have been alright for her to be back as a clinical instructor. She accepts that

the position of a coordinator is only a temporary position and they could be

replaced anytime, with the final decision in the hands of the President.

Maam Lazarraga also told me that one of the new inclusions for

the program of the students is the appraisal, which serves as a question and

answer portion and a sort of review. I commended the program since this was

what I had in mind to suggest to her, so that the students will be able to

rationalize the answers well.

Afterwards, I proceeded to make my teaching plan as she requested.

Thus my practicum was concluded.


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ANALYSIS:

There are three basic steps to time management. The first step requires

that time be set aside for planning and establishing priorities. The second step

entails completing the highest-priority task whenever possible. In the final step,

the person must reprioritize the tasks to be accomplished based on new

information received. Being overwhelmed by work and time constraints lead to

increased errors, the omission of important tasks, and the general feelings of

stress and ineffectiveness.

In performance appraisals, actual performance, not intent, is evaluated.

Performance appraisals let employees know the level of their job performance as

well as any expectations the organization may have of them. Performance

appraisal also generates information for salary adjustments, promotions,

transfers, disciplinary actions, and terminations. When monitoring and assessing

work performance are carried out by peers rather than by supervisors, it is

referred to as peer review. It provides the employee with valuable feedback that

can promote growth. Peers who work together have a level of insight into each

others practice, and peer review provides them with an opportunity to receive

better feedback about self-improvement.

Interpersonal conflict happens between two or more people with differing

values, goals and beliefs. The person experiencing this conflict may experience

opposition in upward, downward, horizontal, or diagonal communication. Highly

developed verbal communication skills are critical for the leader/manager. One

of the most important verbal communication skills is the art of assertive


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communication, which allows people to express themselves in direct, honest, and

appropriate ways that do not infringe on another persons rights.

SYNTHESIS:

Goal met. At the end of my practicum, I was able to suggest

possible ways of resolving commonly encountered problems, observe how the

head nurse manages her clinical instructors, and make a teaching plan as

requested by the preceptor.


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REFERENCES:

Avillion, A. (2003). Nurse Educator Manual: Essential Skills and Guidelines for

Effective Practice. USA: HCPro, Inc

Kelly, P. (2008). Nursing Leadership & Management(2nd ed.). New York: Delmar

Learning.

Marquis. B. and Huton, C. (2003). Leadership Roles and Management Functions

In Nursing: Theory, Concepts, and Applications (4th ed.) Philadelphia:

Lippincott, Williams & Wilkins.

Neeraja, KP. (2003). Textbook of Nursing Education. India: Jaypee Brothers

Medical Publishers Ltd.

Venzon, L. and Nagtalon, J. (2006). Nursing Management: Towards Quality

Care. (3rd ed.). Quezon City: C&E Publishing, Inc.

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