NR 500 Week 5 Discussion: Systems Theory
and Practice Issues
Many of you have experience in complex adaptive systems whether you realize it or not.
Thinking about your current or future practice area, identify an issue or concern. In your
initial response, please describe the concern. Does the concern primarily occur at the
micro, meso, or macro level? How would you address this issue? What impact might
your solution have on the other levels of the system? In what ways could
interprofessional collaboration be used to resolve the issue?
Dr. Myers and fellow classmates,
This week our lesson states that complex adaptive systems “are learning organizations that
embrace uncertainty and can adapt to emerging change” (Chamberlain University, 2019, para
5). I am employed in a hospital setting and this definition is very fitting to describe my work
environment. I work as an RN in the emergency department (ED) and hope to also have a
position there upon completion of my master’s degree. One current issue that we face is staff
safety. We have had more and more instances of patients being violent and aggressive during
their ED visits with many of these outbursts being contributed to drug abuse or psychiatric
disorders. Staff have been kicked, punched, slapped, spit on, knocked to the ground, and/or had
body fluids thrown on them. While there is security in the ED, they are contract employees who
are not law enforcement and state that their contract with the hospital says they cannot touch
the patient without a manual hold order. These situations escalate so quickly that there is never
enough time to get an order to temporarily manually restrain the patient to separate them from
the ED staff.
All units in the hospital have had incidents with patients but the ED and psychiatric center have
the highest incidences of violence towards employees. This means that the concern occurs at
the mesosystem level since the issue is not exclusively linked to one department. To combat
this problem, I believe the hospital should employ law enforcement trained in crisis intervention
that has the capacity to actually protect the staff. Although there would be some defiant patients
who still act out, many are on their best behavior with police presence around in fear of going to
jail. According to Brubaker (2015), responders should use de-escalation techniques but once
the responder’s verbal skills prove to be ineffective and the patient becomes violent, a
responder must resort to the use of a trained defense-oriented response. When the hospital
employs individuals in security who are not trained in defense, a bad situation could turn to
worse. By employing law enforcement as security, safety of employees would also improve on
the microsystem level. I view microsystems within the hospital as individual units. These units
would benefit from having law enforcement to patrol their units in order to promote safety of
these individuals as well. I also feel that those on the macrosystem level would benefit from
having law enforcement presence in the hospital. Not only would there be fewer employee
injuries and time off work, but the hospital would also have highly trained individuals involved
during violent outbursts. This could also prevent patient injury since most entry-level security
position employees are not trained in how to safely subdue a hostile individual. While
interprofessional collaboration within the hospital will not solve the problem, collaborating with
the local police department or law enforcement agency to place officers within the hospital could
This study source was downloaded by 100000829957125 from CourseHero.com on 02-05-2022 21:39:25 GMT -06:00
https://www.coursehero.com/file/47824791/NR-500-NP-Week-5-Discussiondocx/
and Practice Issues
Many of you have experience in complex adaptive systems whether you realize it or not.
Thinking about your current or future practice area, identify an issue or concern. In your
initial response, please describe the concern. Does the concern primarily occur at the
micro, meso, or macro level? How would you address this issue? What impact might
your solution have on the other levels of the system? In what ways could
interprofessional collaboration be used to resolve the issue?
Dr. Myers and fellow classmates,
This week our lesson states that complex adaptive systems “are learning organizations that
embrace uncertainty and can adapt to emerging change” (Chamberlain University, 2019, para
5). I am employed in a hospital setting and this definition is very fitting to describe my work
environment. I work as an RN in the emergency department (ED) and hope to also have a
position there upon completion of my master’s degree. One current issue that we face is staff
safety. We have had more and more instances of patients being violent and aggressive during
their ED visits with many of these outbursts being contributed to drug abuse or psychiatric
disorders. Staff have been kicked, punched, slapped, spit on, knocked to the ground, and/or had
body fluids thrown on them. While there is security in the ED, they are contract employees who
are not law enforcement and state that their contract with the hospital says they cannot touch
the patient without a manual hold order. These situations escalate so quickly that there is never
enough time to get an order to temporarily manually restrain the patient to separate them from
the ED staff.
All units in the hospital have had incidents with patients but the ED and psychiatric center have
the highest incidences of violence towards employees. This means that the concern occurs at
the mesosystem level since the issue is not exclusively linked to one department. To combat
this problem, I believe the hospital should employ law enforcement trained in crisis intervention
that has the capacity to actually protect the staff. Although there would be some defiant patients
who still act out, many are on their best behavior with police presence around in fear of going to
jail. According to Brubaker (2015), responders should use de-escalation techniques but once
the responder’s verbal skills prove to be ineffective and the patient becomes violent, a
responder must resort to the use of a trained defense-oriented response. When the hospital
employs individuals in security who are not trained in defense, a bad situation could turn to
worse. By employing law enforcement as security, safety of employees would also improve on
the microsystem level. I view microsystems within the hospital as individual units. These units
would benefit from having law enforcement to patrol their units in order to promote safety of
these individuals as well. I also feel that those on the macrosystem level would benefit from
having law enforcement presence in the hospital. Not only would there be fewer employee
injuries and time off work, but the hospital would also have highly trained individuals involved
during violent outbursts. This could also prevent patient injury since most entry-level security
position employees are not trained in how to safely subdue a hostile individual. While
interprofessional collaboration within the hospital will not solve the problem, collaborating with
the local police department or law enforcement agency to place officers within the hospital could
This study source was downloaded by 100000829957125 from CourseHero.com on 02-05-2022 21:39:25 GMT -06:00
https://www.coursehero.com/file/47824791/NR-500-NP-Week-5-Discussiondocx/
