NU802 Unit 5 Practice Mentor Seminar Reflection Example

She Wanted Cardiac First and I Wanted 4 West: A Unit 5 Seminar Reflection on Disagreeing With a Practice Mentor

[Student Name]

Purdue University Global

NU802: DNP Project I

Unit 5 Seminar Reflection

[Instructor Name]

[Date]

The seminar, mentor, classmates and project details are composite; the sources cited are real.

The Disagreement

Two weeks before the seminar, my mentor, the hospital's director of nursing quality, read the first draft of my methods section and asked me to change the go-live order. I had planned to start on 4 West and 3 West, the two medical-surgical units most like the pilot units where the bundle already works. She wanted to start on the cardiac step-down unit, which discharges the most patients on new insulin and has the strongest manager in the hospital.

I disagreed, and I said so. My reasoning was that a first spread unit should be the one where success is most likely, so that the project learns how to spread before it meets harder settings. Cardiac step-down has older patients, more family members giving doses and shorter stays. If the bundle struggled there first, I argued, the committee might decide the bundle does not spread at all. She listened, said she understood, and repeated that she still preferred cardiac. We left it unresolved, and I came to the seminar irritated.

What the Seminar Asked

The facilitator opened by asking each of us to describe one disagreement with a mentor and to say what we thought the mentor knew that we did not. I described mine and answered the second part honestly: nothing about the bundle, since I had built it, but perhaps something about the hospital.

A classmate, Odalys, who works in a rural health system, asked a question I could not answer. Why, she asked, would a director of quality want to start with the strongest manager? Was it about the patients or about something the committee needed to see?

I realized I had argued only from the project's point of view. My mentor sits on the committee that approves projects and reports to the chief nursing officer, and she might be thinking about what the first result needs to show to keep support for seven more units. A strong first unit with high volume could produce enough data to show a change within months. Two small medical-surgical units might take a year.

I had treated the disagreement as a question of who was right, when it was a question of what each of us was trying to protect.

What the Literature Helped Me See

Dols et al. (2017) describe the DNP project as caught between the expectations of the academic program and those of the practice site, and they note that faculty, students and clinical partners do not always share a definition of what the project is for. That described our situation exactly. The American Association of Colleges of Nursing's task force on DNP implementation describes the project as work done in partnership with a practice setting, with oversight shared between the school and the site (American Association of Colleges of Nursing [AACN], 2015). Shared oversight means two sets of expectations. My course expected a project designed to learn and to be evaluated well. My mentor's hospital needed a project that would produce visible results soon enough to justify the spread.

Fisher et al. (2011) advise separating positions from interests in a negotiation, asking what each side actually needs rather than defending a stated demand. My position was 4 West first; my interest was learning before meeting the hardest unit. Her position was cardiac first; her interest, as I came to see it, was showing results quickly enough to keep the committee's support.

How We Resolved It

The following week I asked my mentor directly what she most needed the first unit to show. Her answer confirmed Odalys's guess and added something I had not known: the cardiac step-down manager had already asked to be first, and turning her down might cost us a champion. She also told me the sepsis bundle would go live on cardiac step-down in three months, which would make it a poor first unit regardless.

We settled on starting with 4 West and 3 West together, which gives the first go-live more patients than either unit alone, and moving cardiac step-down to the second wave, timed eight weeks after its sepsis go-live. The cardiac manager agreed to join the first-wave huddles as an observer and to lead her own unit's training. My mentor will present the first wave's process measures, which change faster than returns, to the committee after three months.

What I Will Do Differently

Three things will change in how I work with my mentor. First, I will ask what she needs from a decision before I propose one. Second, I will bring her the committee's likely questions along with my drafts, since she knows them better than I do. Third, I will write the reason behind each design choice into the methods section, so that when we disagree we can argue about reasons rather than preferences.

Closing Thought

I came to the seminar thinking my mentor had overruled a sound design decision. I left understanding that she was protecting the project's future at the hospital, a part of the project I had not been watching. The go-live order we chose is better than either of our first proposals, and I would not have found it if Odalys had not asked what my mentor was trying to protect.

References

American Association of Colleges of Nursing. (2015). The Doctor of Nursing Practice: Current issues and clarifying recommendations. Report from the Task Force on the Implementation of the DNP. https://www.aacnnursing.org/Portals/0/PDFs/Publications/DNP-Implementation-TF-Report-8-15.pdf

Dols, J. D., Hernández, C., & Miles, H. (2017). The DNP project: Quandaries for nursing scholars. Nursing Outlook, 65(1), 84-93. https://doi.org/10.1016/j.outlook.2016.07.009

Fisher, R., Ury, W., & Patton, B. (2011). Getting to yes: Negotiating agreement without giving in (3rd ed.). Penguin Books.