Posted: February 22nd, 2025

Response to Change-Readiness Assessment (NUR 448 Leadership)

Instructions
Change can be a key stressor interfering with team dynamics, collaboration, and civility. Understanding how to adapt to change is essential for maintaining a positive work environment. The healthcare system is in a constant state of change, ever evolving, and this can lead to poor teamwork and possible incivility in the workplace. Complete the Change-Readiness Assessment Download Change-Readiness Assessment.

Read the “Understanding Your Scores” section of the assessment for a summary of the assessment, along with a reflection of your highest and lowest scoring areas. This reflection will help you identify areas for growth and improvement.

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Create a Microsoft Word document and include the following:

In 3–5 sentences, answer the following question: How will the scores in these areas affect your professional development? Consider how your strengths and weaknesses align with your career goals.
Write a personal mission statement that highlights your strengths based on the assessment. Include at least one strategy to improve your three lowest-scoring areas on the assessment in your personal mission statement. This will serve as a roadmap for your growth as a healthcare professional.
Read “21 Personal Mission Statement Examples and How to Make Your OwnLinks to an external site.” for help on writing your personal mission statement, if needed.

Citations:
Jenney, T. J. (n.d.). Change-readiness assessment. https://continuinged.uncc.edu/upload/Change-Readin...
Wright, B. (n.d.). 21 personal mission statement examples and how to make your own. TheLifeSynthesis. https://thelifesynthesis.com/personal-mission-stat...

Additional References:

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American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements.

Goleman, D. (1995). Emotional Intelligence: Why It Can Matter More Than IQ. Bantam Books.

Kouzes, J. M., & Posner, B. Z. (2017). The Leadership Challenge: How to Make Extraordinary Things Happen in Organizations. Jossey-Bass.

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NUR 448 Leadership

Scenario
You are a newly hired RN. A senior RN with many years of experience gives you an orientation and additional training on the medical unit to which you are assigned. Building a strong relationship with your mentor is crucial for your professional growth. Although you graduated from a baccalaureate program, there are several procedures with which you need to become more proficient. The senior RN is providing instructions on these procedures and closely watches every move you make.

Female patient, appears agitated in hospital bed/wheelchair.

One day you are providing care for Gina, a highly agitated patient who has been diagnosed with general anxiety disorder and is awaiting transfer to the mental health unit. The provider has ordered diazepam (Valium) IV push as needed to decrease anxiety. You and the senior RN agree that the patient is displaying acute anxiety and requires medication. The senior RN instructs you to “push the diazepam IV” through a port in the IV tube near the insertion site of the needle in the patient’s hand.

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You remember from one of your clinical sessions in the ICU that the only IV solution used when pushing IV diazepam is normal saline, and it should be pushed through a large vein in the arm, not a small vein in the hand. The IV solution currently hanging on the patient is D5W. When you question the procedure that the senior RN has suggested, she says, “Look, this is how we do it here, missy. We are understaffed and do not have the time to switch the IV over to normal saline. When you push it in a port close enough to the IV site, it doesn’t matter what solution is hanging. If you want to work here, that is how you will do it.”

Critical Thinking Questions

How should you respond to the senior RN demanding the medication be given with the current solution?

What are the possible consequences of administering the medication this way?

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What difficult behaviors is the senior RN displaying?

Provide at least two strategies to communicate and work with the senior RN during this scenario.

Additional References:

Institute for Safe Medication Practices. (2020). Guidelines for Safe Medication Administration.

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Marquis, B. L., & Huston, C. J. (2021). Leadership Roles and Management Functions in Nursing: Theory and Application. Lippincott Williams & Wilkins.

The Joint Commission. (2023). National Patient Safety Goals.

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NUR 448 Leadership

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Instructions
Change can be a key stressor interfering with team dynamics, collaboration, and civility. The healthcare system is in a constant state of change, ever evolving, and this can lead to poor teamwork and possible incivility in theworkplace. Complete the Change-Readiness Assessment Download Change-Readiness Assessment.

Read the “Understanding Your Scores” section of the assessment for a summary of the assessment, along with a reflection of your highest and lowest scoring areas.

Create a Microsoft Word document and include the following:

In 3–5 sentences, answer the following question: How will the scores in these areas affect your professional development?
Write a personal mission statement that highlights your strengths based on the assessment. Include at least one strategy to improve your three lowest-scoring areas on the assessment in your personal mission statement.
Read “21 Personal Mission Statement Examples and How to Make Your OwnLinks to an external site.” for help on writing your personal mission statement, if needed.

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Always! We start from scratch—no copying, no AI—just pure, human-written work with solid research and citations. You can even get a plagiarism report to confirm it’s 95%+ unique, ready for worry-free submission.

Citations:

Jenney, T. J. (n.d.). Change-readiness assessment. https://continuinged.uncc.edu/upload/Change-Readin...

Wright, B. (n.d.). 21 personal mission statement examples and how to make your own. TheLifeSynthesis. https://thelifesynthesis.com/personal-mission-stat...

___________________________________

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NUR 448 Leadership

Scenario

You are a newly hired RN. A senior RN with many years of experience gives you an orientation and additional training on the medical unit to which you are assigned. Although you graduated from a baccalaureate program, there are several procedures with which you need to become more proficient. The senior RN is providing instructions on these procedures and closely watches every move you make.

Female patient, appears agitated in hospital bed/wheelchair

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One day you are providing care for Gina, a highly agitated patient who has been diagnosed with general anxiety disorder and is awaiting transfer to the mental health unit. The provider has ordered diazepam (Valium) IV push as needed to decrease anxiety. You and the senior RN agree that the patient is displaying acute anxiety and requires medication. The senior RN instructs you to “push the diazepam IV” through a port in the IV tube near the insertion site of the needle in the patient’s hand.

You remember from one of your clinical sessions in the ICU that the only IV solution used when pushing IV diazepam is normal saline, and it should be pushed through a large vein in the arm, not a small vein in the hand. The IV solution currently hanging on the patient is D5W. When you question the procedure that the senior RN has suggested, she says, “Look, this is how we do it here, missy. We are understaffed and do not have the time to switch the IV over to normal saline. When you push it in a port close enough to the IV site, it doesn’t matter what solution is hanging. If you want to work here, that is how you will do it.”

Critical Thinking Questions
How should you respond to the senior RN demanding the medication be given with the current solution?
What are the possible consequences of administering the medication this way?
What difficult behaviors is the senior RN displaying?
Provide at least two strategies to communicate and work with the senior RN during this scenario.

_____________________________
Response to Change-Readiness Assessment (NUR 448 Leadership)
Completing the Change-Readiness Assessment revealed key insights into my ability to adapt to change, a vital skill in the ever-evolving healthcare environment. My highest-scoring area was resourcefulness, suggesting I can effectively find solutions in dynamic situations, while my lowest-scoring area was optimism, indicating a need to build confidence in viewing change positively. These scores shape my professional development by highlighting strengths to leverage and weaknesses to address as I grow into a leadership role.

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The resourcefulness score boosts my confidence in handling unexpected challenges, such as adapting to new protocols or managing team conflicts. However, lower optimism could hinder my ability to inspire others during stressful transitions, a critical aspect of nursing leadership. Improving this area will enhance my resilience and support better team dynamics over time.

Personal Mission Statement
As a nurse committed to excellence, I strive to harness my resourcefulness to deliver compassionate, patient-centered care while fostering collaboration in diverse teams. My strength lies in creatively solving problems under pressure, ensuring quality outcomes for patients and colleagues. To address my lower-scoring areas—optimism, adaptability, and tolerance—I will actively seek feedback from mentors to build a positive outlook, practice flexibility by embracing small changes daily, and attend stress management workshops to strengthen my resilience in high-pressure settings.

Response to Scenario-Based Critical Thinking Questions (NUR 448 Leadership)
Healthcare settings often present complex situations requiring both clinical judgment and interpersonal skills. The scenario involving Gina, a patient with acute anxiety, and the senior RN’s directive to administer diazepam (Valium) IV push improperly raises ethical, safety, and teamwork concerns. Below, I’ll address the critical thinking questions systematically.

How Should You Respond to the Senior RN?
Respectfully addressing the senior RN’s directive is essential to maintain professionalism while prioritizing patient safety. I would calmly say, “I appreciate your guidance, and I want to ensure we’re doing what’s safest for Gina. My training emphasized using normal saline with IV diazepam through a larger vein to avoid complications. Could we discuss switching the IV solution to follow that standard?” This response acknowledges her experience, expresses a willingness to collaborate, and firmly advocates for evidence-based practice without escalating tension.

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What Are the Possible Consequences of Administering the Medication This Way?
Administering diazepam IV push through a small hand vein with D5W instead of normal saline carries significant risks. Diazepam is poorly soluble in solutions like D5W, which can lead to precipitation, clogging the IV line or causing vein irritation (Lexicomp, 2023). Pushing it into a small vein increases the chance of phlebitis or tissue damage, especially since diazepam should be given slowly through a larger vein to minimize irritation (Adams and Urban, 2021). These complications could worsen Gina’s condition, delay her treatment, and expose the team to legal or ethical repercussions.

What Difficult Behaviors Is the Senior RN Displaying?
The senior RN exhibits several challenging behaviors. First, her dismissive tone—“missy” and “this is how we do it here”—reflects condescension and resistance to questioning, undermining a culture of open communication. Second, her insistence on cutting corners due to time constraints suggests a lack of accountability, prioritizing convenience over safety. Finally, her defensive reaction to feedback indicates inflexibility, which can stifle teamwork and discourage new nurses from speaking up.

Strategies to Communicate and Work with the Senior RN
Navigating this situation requires tact and collaboration. Two effective strategies include:

Use Reflective Listening and Seek Clarification: Start by saying, “I hear that we’re short on time, and I want to help make this efficient. Can you explain why this method works here despite the guidelines?” This validates her perspective, encourages dialogue, and subtly reinforces standards without confrontation.
Propose a Team-Oriented Solution: Suggest, “How about I quickly switch the IV to normal saline while you monitor Gina? That way, we stay safe and keep things moving.” This frames the correction as a joint effort, reducing defensiveness and aligning with shared goals.
These approaches foster mutual respect, prioritize patient care, and build a foundation for constructive teamwork despite initial friction.

Conclusion
Both exercises underscore the importance of adaptability, communication, and evidence-based practice in nursing leadership. The Change-Readiness Assessment highlights personal growth areas that will enhance my professional journey, while the scenario with the senior RN emphasizes balancing assertiveness with diplomacy in real-world challenges. Together, they reinforce that effective leadership in healthcare hinges on self-awareness and collaboration.

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References
Adams, M. P., & Urban, C. Q. (2021). Pharmacology: Connections to Nursing Practice. Pearson.
Jenney, T. J. (n.d.). Change-readiness assessment. University of North Carolina Continuing Education. Available at: https://continuinged.uncc.edu/upload/Change-Readin...
Lexicomp. (2023). Diazepam: Drug Information. UpToDate. Available at: https://www.uptodate.com/contents/diazepam-drug-information
Wright, B. (n.d.). 21 personal mission statement examples and how to make your own. TheLifeSynthesis. Available at: https://thelifesynthesis.com/personal-mission-stat...
Yoder-Wise, P. S. (2019). Leading and Managing in Nursing. Elsevier.

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