Category: Nurse

“Where there is a will, there is a way. If there is a chance in a million that you can do something, anything, to keep what you want from ending, do it. Pry the door open or, if need be, wedge your foot in that door and keep it open,” a quote by Pauline Kael. It has been one of the quotes I live by. Growing up in Ghana (West Africa) have always wanted to be a nurse. I started imitating what nurses do at a younger age, even role play as a nurse with my dolls and sometimes with friends.

My Grandma was a nurse and I watched her care for her patients and some family relatives who were ill. Back then in Ghana it was hard to choose your choice of career because whatever your Parent profession is, you will also have to go into that profession. My Father majored in business, so he wanted me to major in business. I had no choice but to major in business. When I had the opportunity to join my Mom in the States, I enrolled in community college to continue my education. In the community college, I decided to not abandon my dream of being a nurse, so my goal was to take prerequisite for nursing school and to do well in those classes and earning a good GPA for easy transfer to Nursing school. Recently,

Personal goals for Nursing

• Every make sure am able to think critically, that is to think clearly and make rational decisions
• Ensure that I good grades on quizzes, exams etc. But not only good grades but also make sure I understand the nursing concept.

The following are the things to do in order to attain my goals

• Staying healthy not being health will have negative impact on my education.
• Avoiding Procastination, as they always say procastination is a thief of time. I have to do my assignment on time and not wait to the last minute to study for exam.
• Asking my Professor for help when am having hard time understanding a course or assignment.
• Being organized will help me reduce stress.
• They are many resources to help me with my studies, things like flashcards, nursing videos on the topic of interest will help me study. I will look up for videos for topics that are to be thought in that particular week. Moreover, youtube has a lot of videos on topics for a nursing course. The evolve website is also helpful when it comes to studying about a particular chapter to be tackle in that week.
• Not spend too much time on social media.

This essay will be exploring what spirituality is and why it should be incorporated in holistic care, how it is different from religion, and the role of a nurse in delivering spiritual care.

Narayanasamy (2004) suggests that “Spirituality is defined as the essence of being and it gives meaning and purpose to our existence.” Spirituality is a practice of seeking hope, meaning, and purpose of the life (Rogers and Wattis, 2014). Dictionaries (2018) describes religion as ‘belief in … especially god or gods.’ Some people will view their faith as a source of spirituality; hence religion can be spiritual. However, individuals can be spiritual without being religious, or religious without being spiritual (Rogers and Wattis, 2014).

When an individual faces crisis and illness, they may desire to discuss spiritual issues; nurses may be able to address any spiritual distress by being responsive and sensitive to these signals. It is also essential to consider how nurses can approach these spiritual issues if the patients do not raise them directly. It is important to address the patient’s spiritual need to provide holistic care (Rogers and Wattis, 2014). Holistic care is a care that considers the ‘whole person’ and not merely the condition or illness the person has. Holistic care recognises the uniqueness of the individual, personality and the individuality in them (Brooker and Waugh, 2013). Unquestionably an individual’s physical health is related to mental health and their soul, in other words, body, mind, and soul are interlinked. Wright (2005) states “Spirituality and health are linked to each other, inseparable companions in the dance of joy and sadness, health and illness, birth and death.”

Nurses require a degree of cultural competency and an ability to distinguish and recognise patient’s spiritual issues. Nurses must be aware of what spirituality means to the particular patient and respect the patients’ choices, and nurses should not impose their own values and beliefs upon patients (Williams, 2016).

Although spiritual care is recognised today, it is often neglected as some nurse view religious and spiritual needs as a private matter, lack knowledge about it, and view these needs as a family and pastoral responsibility (Williams, 2016). To deliver holistic care, nurses need to address the patient’s spiritual needs along with other biopsychosocial needs. Spiritual care would include nurses recognising patient’s spiritual practice/restriction, identifying who can help patients with spiritual support, providing opportunity to express their spiritual needs and concerns, determine spiritual objects that have meaning to the patients, provide opportunity for spiritual guidance with respect for privacy, and encourage contact with a spiritual counsellor in times of crisis (Williams, 2016). Nurses could use models like ASSET (Narayanasamy 2006) to exploit spirituality and spiritual care. According to ASSET model, nurses should have self-awareness of their own beliefs and values which should not influence the way they deliver care, what spirituality means to them and what is spiritual nursing (Ellis and Narayanasamy, 2009).

Integrating spirituality into the practice leads to more holistic care, increases nurse-patient therapeutic relationship and improvement in recovery rate. The meaning to spirituality can differ from one person to another. For some people, religion can be a source for their spirituality, but that does not mean one has to be religious to be spiritual or spiritual to be religious. Spirituality may mean more to an individual during the time of crisis; it may only be the foundation of hope for them or a form of practice where they can submerge their sorrows and griefs.

Cultural competence in Nursing

This essay shall be looking into the cultural impact that nurses should be aware of when delivering care, what culture means, and what cultural competence is.

Leininger (1991) defines culture as the ‘learned, shared and transmitted values, beliefs, norms, and lifeways of a particular group that guides their thinking, decisions, and actions in patterned ways.’ (Burnard and Gill, 2013). It is important to remember that the component of culture is always changing with time and evolving. It consists of a family or society tradition, beliefs, values, rituals, and norms that have been passed down from many generations (Brooker and Waugh, 2013). Culture is an umbrella term used for a collection of different types of culture. There are various types of cultures such as individual, group, society, work and so on. When an individual enters an unfamiliar culture and realises the difference suddenly or gradually, this is known as culture shock (Burnard and Gill, 2013).

Nurses are expected to illustrate effective cross-cultural communication and deliver culturally competent nursing care to people from diverse backgrounds, cultures, and ethnicity (Andres and Boyle, 2016). Care given to the patient by the nurse should be person-centred care (McCormack and McCance, 2017). One of the principles of PCC is to provide holistic care and secondly to work with the patient’s beliefs and values (McCormack and McCance, 2017). In some cultures, and religion, modesty is important and so patients would not be happy wearing revealing hospital gowns, or to be seen by opposite-sex healthcare workers. Another instance would be, patient refusing medical interventions, for example, blood transfusion or tissue transplant not being permitted by Jehovah’s witnesses. To a nurse, this may come across as an unwise decision or patient being difficult, but nurses need to respect that choice made by the patient to maintain patient’s autonomy (Brooker and Waugh, 2013).

To deliver holistic care, nurses must be sensitive to patients’ and patients’ family’s cultural expectations, with no stereotype assumptions. Nurses should have basic cultural awareness. Nurses need to gain information on their patient’s culture, show empathy through verbal and non-verbal communication skills, nurses should listen with open-mindedness and be non-judgemental, and show a willingness to learn (Burnard and Gill, 2013). Cultural competence is a process of acquiring specific knowledge of how to respond to the demands of cultural diversity, awareness, and sensitivity. It is an action portrayal of behaviours that help to minimise or eliminate the differences and barriers that often occur when people of diverse cultures interact and communicate (Schim and Doorenbos, 2010). This process includes five components: cultural awareness (self-examination of one’s background, prejudices, and assumption about others), cultural knowledge (obtaining sufficient knowledge of diverse groups), cultural skills (recognising factors influencing treatments and care of patients), cultural encounters (engaging in cross-cultural interactions) and cultural desire (accepting the role of a learner with open mind, accepting cultural differences and building on similarities) (Potters., et al, 2013).

People should be treated equally regardless of what their culture is, which may consist of beliefs, values, and norms that may be contrary to that of a nurse. Nurses must be able to deliver culturally competent care to the patients especially in today’s U.K.’s diverse community today.

Understanding of the nurse’s role in safeguarding

Safeguarding is a very complex topic; it can relate to children, adults or anyone with protected characteristics such as gender reassignment, disability, pregnancy, and maternity, learning disability, belief or non-belief, sex, sexual orientation or age. Therefore, this essay shall be focusing on adults safeguarding; it shall look into what makes adult vulnerable, safeguarding referrals and how safeguarding protects them.

Department of Health (2014) defines safeguarding as protecting individuals’ right to live a safe life, free from abuse and neglect (Griffith, 2015). Harm and abuse include behaviours that are defined as harassment under the Equalities Act 2010. It is also evident that people with particular protected characteristics are more susceptible to harm, abuse and neglect (DH, 2014).

According to the Care Act (2014), safeguarding applies if a local authority has a reasonable cause to suspect that an individual has needs of care and support (whether they are receiving care or not), and as a result of those needs is unable to protect him/herself against the abuse or neglect or the risk of it.

The Care Act (2014) focuses more on different forms of abuse rather than categorising people as vulnerable. The different types of abuse outlined in the Act are physical abuse, domestic violence/abuse, sexual abuse, psychological/emotional abuse, modern slavery (Human trafficking, forced labour), discriminatory abuse, organisation or institutional abuse, neglect or act of omission and self-neglect (Dalphinis, 2016).

Nurses role also include safeguarding their patients. Nurses need to abide by all the domains in ‘The Code’ (2015); and according to the code, nurses need to preserve the safety of their patients (The Code, 2015). Nurses have a duty of care to safeguard vulnerable adults from abuse and neglect. Safeguarding is important as it promotes human right and equality through sets of safeguarding principles, which are empowerment, protection, prevention, proportionality, partnership, and accountability (DH, 2014). An individual who is capable of giving their consent has the right to refuse treatment, and this must be respected. According to one of the principles of Mental Capacity Act (MCA) (2005), nurses must assume that an individual has capacity unless proven they lack capacity. Secondly, nurses should take all practicle steps to meet their patient’s needs and wishes. The third principle of safeguarding is that patients are allowed to make their own decision; even if it may seem unwise to the nurses. Another principle is that nurses must act in the patient’s best interest if the patient lacks capacity meaning that the patient is unable to understand and retain information, make a decision, and weigh the information. The last principle is to ensure the least restrictive option is taken (Nhs, 2017).

Safeguarding concerns should be raised where any form of abuse is reported or suspected. It is nurse’s role to raise the concern, take timely and appropriate actions to investigate further and refer the concern on to an appropriate body such as safeguarding leads, Care Quality Commission or local authority (Griffith, 2015).

Nurses need to be aware not just of people who are vulnerable, but they should be able to recognise different forms of abuse. It is nurses’ duty of care to safeguard patients and colleagues as it is a human right of everyone regardless of protected characteristics that they can live safely, free from abuse and neglect.

Introduction

This essay will discuss communication and teamwork, by choosing these two essential skills in not just health care but all aspects of life, I aim to enhance my knowledge and understanding which I hope will improve my professional competence. These two valuable skills are closely linked as effective communication, mutual support and team leadership all contribute to successful teamwork (Baker et al, 2012). In fact effective communication may be seen as one of the most important components of teamwork (Sorbero, 2008), for a team to work collaboratively together to achieve shared outcomes both formal and informal communication must take place regularly, with all team members listening and paying attention to not only verbal communication but also non-verbal and written (Butler and Rose, 2011).

With both topics being wide ranging this assignment will focus on certain elements of both skills, it will firstly identify what is meant by both skills and why they are so vital within a healthcare setting, discuss how good communication and teamwork contributes to effective patient care and satisfaction and how poor communication and teamwork can pose a risk to patient care and wellbeing, it will also touch on some potential barriers in both communication and teamwork.

It will discuss evidence from both research and clinical practice and how this has impacted my learning and development. During and after writing this essay I will collect, treat and store any relevant research findings suitably and ensure they are kept securely in line with the Nursing & Midwifery Council, Code of Conduct (NMC, CoC) (2018), all names and places will be anonymised to protect the identity of both patient and organisation.

Throughout this essay I will collect, treat and store any relevant research findings suitably and ensure they are kept securely in line with the Nursing & Midwifery Council, Code of Conduct (NMC, CoC) (2018), all names and places will be anonymised to protect the identity of both patient and organisation.

Communication

Defining communication

There are more than seven complex communication models, this section will focus on just three to define what communication is. In 1948, early theorists thought of communication as Linear, a simplistic way to view the human interaction or communication in the form of; sender sends a message via a channel to the receiver (Narlua, 2006, pp5), the two elements appear to relate to verbal communication only. The circular model proposed by Wilbur Schramm in 1955 suggested communication is a circular process comprising of three key elements – encoding (putting message in channel), decoding (retrieving message) and interpreting (understanding of or responding) (Bhatnager,2011, pp98), also known as interactive model. He demonstrated communication as a two way process in which both sender and receiver use verbal and non-verbal forms of communication, whilst sender is speaking the receiver is listening, the roles are then reversed throughout the exchange (Boyd & Dare, 2014, pp4). The transactional model takes the interactive model and includes non-verbal aspects of communication such as body language, eye contact and facial expressions, the rate, tone, volume and pitch of speech, silences and gestures and written communications.

Importance of communication in healthcare

Communication is so imbedded in day to day life be it; a conversation with family at the breakfast table about the days plans, a discussion with work colleagues about the latest TV program, an important phone call, the first interaction with a stranger or a comment on social media, yet often little or no consideration is given to such a complex phenomenon. There are many reasons why we communicate such as; to elicit or give information, to feel included, to express ideas and influence others, relay feelings or emotions, to strengthen social relations and build trust or simply to pass the time of day. Some communications are forgotten immediately whilst others can last a lifetime. Needs a ref

The (student) nurse-patient relationship begins with the introduction, the patient doesn’t get to choose their nurse, nor does nurse choose patient, there may be notes or a brief handover available. However it is the role of the nurse to build a rapport with the patient in order to gather as much information as possible to allow the best quality of care to be provided. (insert ref) Whilst on placement in a community setting managing service users living with addictions, completing an initial assessment with a homeless male patient, I witnessed a nurse communicating therapeutically. (explain what I mean and add reference)

By greeting the patient and introducing themselves calmly, using open body language, appropriate words and tone, then kindly asking the patient about their problems, keep appropriate eye contact whilst listening to the response and noticing patient reactions. (pat wants a reference) The patient advised that they had no yet eaten today and had no money to purchase any food, that he had looked into a few of the shop bins but it was too early in the day for them to throw food away. The nurse empathised how difficult it must be to live in this way and offered a short term solution to this problem by providing the patient with a list of places near-by where he can go to get a hot meal each day and some essential supplies to take away, the nurse also issued a food voucher and explained where to take it. (Pat wants ref – ? direct gov webite about food vouchers) Whilst the nurse continued with the appointment I offered to make him a hot drink and even found some biscuits. During the appointment the patient began to get emotional and explained he was grateful for the help the nurse had given him and that she hadn’t judged him as he felt so many others did. (pat wants to know how it relates to the literature, code of conduct maybe ?)

Wider reading would help you to understand and discuss this more?

This part of your work is very descriptive due to lack of literature to support.

You could also consider the NMC Code of Conduct NMC 2018 in your work.

You might like to consider the materials on CANVAS re the assignment? Pats words. I have done not much more than read, the amount of books I have accessed is many, plus I have accessed the material on canvas, but I am not fully understanding it hence the questions.

The nurse took the time to listen to his story about how he came to be homeless and that he had been introduced to substances by another homeless person and that using heroin was the only way he could get through life as it is now because it took away all physical and emotional pain, the patient expressed his awareness of how dangerous it was and that he has tried to stop but has found it too difficult. The nurse reflected that life must be very hard at this time and that he seems to be struggling to develop any new coping skills and that using heroin seems to make life both easier and harder at the same time. (pat – how did this help him?)

They used verbal and non-verbal communication, made gestures and showed empathy and unconditional positive regard. (Pat says how?)By interacting mindfully and not making judgement but accepting that he feels it is too difficult to stop using heroin whilst he remains homeless. The nurse created an environment where the patient felt they could share information, which helped to build trust and enabled the nurse to gather vital information which may have been missed had she not had the time to listen to him

This is such an important part of healthcare, where effective communication is the key to…………….don’t know what else to write at this point.

Pat says all that section is wrong anyway so needs to be changed if I ever get to the end.

• Good communication
• Poor communication
• Potential Barriers

This report will focus on the specific barriers witnessed during my practice placement which are; language barriers and challenging/aggressive behaviour.

challenges in communication where there may be a language barrier or challenging/aggressive behaviour as these seem to be common challenges within the client group in my current role, this will be discussed in further depth later in this report. )????

What I have learned from my practice with examples, why I learned what I did and how it has influenced my own practice and development

the majority of our client group have complex physical and mental health needs, poverty, unemployment, homelessness, criminal justice involvement, social services involvement, there are also many eastern Europeans, from diverse cultural backgrounds that are far away from home, family members and support networks, which can often result in anger and frustration directed towards other clients, staff members or other professionals though the cause is often unrelated to our service provision.

Teamwork 40% waht is teamwork – MDT, why this is important in nursing, respect the importance of the different roles within the MDT and why and how they are important in effective patient care, discuss how ineffective teamwork, poses a risk to patients and health care profession, some possible challenges of teamwork, examples from my practice, teamwork I have witnessed, how I have worked as part of MDT to meet the needs of patients yet remained within professional and legal frameworks, worked within my area of competence and professional, organisational and legal boundaries, worked effectively as part of the MDT to safeguard children and vulnerable adults, what was and wasn’t effective and why, understanding I am accountable for my own actions, the importance of reflection, supervision and documentation, reflect what I have learned and why. Relate all statements to the literature

Bibliography

1. Baker DP, Salas E, Battles JB, King HB (2012) The relation between teamwork and patient safety. In Carayon, P (Ed) Handbook of Human Factors and Ergonomics in Health Care and Patient Safety. Second edition. CRC Press, Boca Raton FL, pp. 185-198.
2. Butler, M. and Rose, E. (2011). Introduction to organisational behaviour. London: Chartered Institute of Personnel and Development, pp.154.
3. Nursing & Midwifery Council. (2018). The code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. [Online] Available at http://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/revised-new-nmc-code.pdf [accessed 1st May 2019]
4. Sorbero, M. (2008). Outcome measures for effective teamwork in inpatient care. Santa Monica, CA: RAND Corp., pp.1.

I have wished to be a neonatal nurse since before I could even remember. Something about their work and ambition drove me into wanting to follow that career path for my own. Becoming a neonatal nurse has been a dream of mine for a long time now. I’ve done the research, I’ve talked to other neonatal nurses to get all sides of the career itself, such as the good, the bad, and the ugly, which all careers most certainly come with.

​What exactly is a neonatal nurse? A neonatal nurse is an RN (Registered Nurse) that specifically works in the Neonatal Intensive Care Unit (NICU). A neonatal nurse is responsible for monitoring the fragile newborns, while they are still required to be in intensive and overseen care, before they are allowed to go home with their new excited but worried parents. This is a very important role in any hospital. Some infants will stay in the NICU up until one year after their birth in a number of different facilities. This can be very hard to see, when you love and have passion for newborns and grieving families. Neonatal nurses are responsible for caring for these infants who have medical ailments and need specialized care, opposite of a healthy newborn baby that would get to go home with its parents within 2-3 days. Being in the NICU is a much longer and painful process and it takes skilled and trained people to be able to do this job.

​That is why this job is so interesting to me. Not only do I love babies and know that I would feel connected to each and everyone while caring for them, I feel that neonatal nurses gives newborns a very loud voice for others to hear them, when they are too quiet. Of course this is strictly metaphorical, it is very important to be able be caring and love infants and their families in order to perform this career correctly, and be happy at the same time in your career choice.

​According to RegisteredNursing.Org the certifications and credentials needed to be able to work as a neonatal nurse are as followed: Must be a RN in the US of Canada, Must have been employed in a neonatal nursing position for the last 2 years, must have at least 2,000 hours in the neonatal experience in working directly with patients, education, patient care, and research, Or have at least 2 years of experience working completely with medically ailed infants patients. NICU nurses aren’t just needed in hospitals. You must also obtain a 4 year Bachelor of Science in Nursing degree. Neonatal nurses can also be employed with community organizations, charity work, home health care, hospitals, and also NICU (which is its own floor in most hospitals and is considered to be separate.)

​ They are different levels to being a neonatal nurse. In total there are 4 different levels which are as followed: Level I: (Basic Newborn Care) postnatal care in newborns that may have been born within 35-37 weeks in the gestational period. This is just to monitor the baby, considering that this is considered a premature birth. This mostly requires basic care of a newborn with some specialized aspects depending on the newborns health and what they may or may not have trouble with after exiting the womb. . Level II: (Advanced Neonatal Care) An experienced neonatal nurse who will assist the newborn in whatever ailments they have medically such as breathing or feeding. Level III: Specialty newborn care) RN’s working on this level would be working with babies born before 32 weeks gestation. These babies are considered severely premature and will need a lot of excessive and precise care. Level IV: (Highest Level of Neonatal care) These level nurses provide care of newborns who are born as young as 22-24 weeks gestation. These nurses assist with open-heart surgeries if needed, heavy ventilation for baby, and other hefty procedures that the babies health may call for.

​Although the pay range for a neonatal nurse mean the least to me, the normal rationed pay for a neonatal nurse is roughly $60,000 annually. As to where are Neonatal nurse practitioner can make upwards of $93,000 annually. The demands for RN’s are robust, as they are needed practically everywhere there is medical care and well, babies. Like any career, there are negative and positive aspects to this career. Of course looking from the outside in, it seems pretty simple right? You’re able to hold and cuddle babies all day, and then they go home and you’re on to the next cute and sweet little ray of sunshine. Wrong. There are very dark times while working as a Neonatal nurse. There are times where a newborns condition is just irreversible and you have to see them suffer. Or when one baby is fine and just needs a little extra oxygen and can go home with their mommy and daddy within the next couple of days, and then the next baby to come in doesn’t get to go home at all with their parents. Not all case is the same, there are nightmares that go on in neonatal nursing as well.

​What is the history of neonatal nursing? Where did it come from? We all know that medical advances have drastically changed within the decades/centuries. Women have always had children, but Neonatal nursing hasn’t always been around. Neither have NICUs or hospitals. So what did a couple do decades ago if there was an issue with the baby or pregnancy? When did neonatal nursing come about? Almost a century ago, NICUs didn’t exist. Many babies that were sick or had birth defects and diseases were just sent home from the hospital anyways because they didn’t have the type of care or knowledge in hospitals yet, to do any type of intensive care for infants. Most infants who were sent home, unfortunately would die before their 1st birthday arrived. This happened severely more often than it does now, only because throughout the years, advances have been discovered in medical, medicines, diseases, treatments and diagnosis.

​The first NICU wasn’t created until 1922, however specialized care for newborns weren’t available until the late nineteenth century. This was so unfortunate for all the sick babies who were sent home before and died before they were even able to remember or live their life. It was not until long after World War II that hospitals began to create special care units for infants. This idea was created when professionals realized that heat control, humidity control, and a steady flow of oxygen could drastically increase the chances of a sick baby to recover and be able to live a healthy life with their parents.

​How do neonatal nurses define themselves? What drives them to do such a personal job? When you think about all the pain and grief that you’ll encounter whilst employed at a NICU, you wonder how on earth do other neonatal nurses do this job everyday and are perfectly okay? While interviewing a friend of mine who is a neonatal nurse, I asked her these exact questions. She stated “I have children, 3 of them to be exact. This is the hardest job that I have ever had to do. I am thankful for my healthy children every single day because of this career.” She stated. “I see babies leave out of here almost everyday with their parents, and some days I see their parents leave without them, because either they were too sick to take home, or they didn’t make it there.” “I know this job is crazy, especially when I get to go home to my children every single day. I think about those mommies and daddies who can’t hold their babies, or love on them and it honestly it makes me sad.” She said. “I just want to give each and every baby that comes through that door a fighting chance because they deserve it. No matter how much pain it bears on my heart, I am helping them and that triumphs anything else in my opinion.” Which concluded her statement. I think that this career is very hard on the Neonatal nurses themselves, I am sure they understand that they are seen as heroes, but they just want to be there for the baby and make sure that they have the best fighting chance possible. They know that they will fight for any baby, when they are too weak to fight for themselves.

​What are some positives and negatives about working as a neonatal nurse? According to an article on nurse buff, these are some pros and cons working as a neonatal nurse. Cons: Pressure at work, Mental agility and stability, (you literally have a living human beings life in your hands. Their fate almost fully depends on the care that they receive while in the NICU. Emotional stress and Ethical issues. There will always be something that happens while in nursing that you don’t remember reading or studying about. Something that isn’t in a textbook or study guide. This is where you will have to be ethical and use ethical reasoning and problem solving. What are some pros? Besides the obvious being able to look at extremely adorable baby faces all day, other pros are: positive opportunities for career and personal growth, nurturing skills, physically less demanding than other nursing positions, and emotionally fulfilling.

​I know that becoming a neonatal nurse can be extremely difficult, time consuming, mentally draining, emotionally draining, and downright hard. There is so much that goes into being a good neonatal nurse. One of course is knowledge. You’ve just got to know your stuff. I am going to be put into situations where I will have to know certain things that I probably didn’t think I would have needed to remember. Two, having compassion. You can’t care for others, especially sick babies, if you don’t have compassion and love for others. This is very important because the quality of care that you give will reflect on you personally and the type of person that you are. If you don’t like children or if you aren’t a compassionate and loving person, then one, the medical field isn’t the place for you, and two, you should not be caring for infants who will strictly depending on you.

​By becoming a neonatal nurse, I understand what my duties will be to fulfill that role to the best of my ability. But I also know how hard it will be at times. I would like to say that I will not get personally attached to the patients, but I personally feel like the best care will come from the nurses who are attached to their patients, and will care for them as if they were a parent or if they were caring for their own children. In my opinion, this is extremely important.

​In conclusion, I am sure we can all agree that neonatal nursing isn’t the easiest career out there. But I do one hundred percent believe that it is one of the most hard working, compassionate, loving, nurturing, and caring career that I could ever ask for. This is not a career for the weak minded or hearted. This career is for someone who is strong-willed and someone who believes in themselves and know and understand that making a difference and saving lives is the most important thing you could ever do. Looking back as a little girl when I would always dream about working with babies, and being around them all the time in a nursery, I never fully grasped the complexity of this career.

​There is so much pain, hurt, compassion, and knowledge that go into becoming a neonatal nurse. I am proud of myself for staying on this path, and one day completing my goals and becoming the best neonatal nurse that I can be.

​In my opinion, being a neonatal nurse is not a career but a duty. This isn’t about just a paycheck to me, but about how many lives that I can change for the better by the end of my shift. This is about how many families, I can make whole by ensuring them that they would be able to take a health baby home with them.

My Personal Philosophy of Nursing

Nursing is a noble profession of caring for an individual, family, group or community to uplift their health status. Since I was a child the two main values I have inculcated is caring and empathy for other who is need by any means when I joined nursing in first year after studying fundamentals of nursing as a course I developed my philosophy and according to my point of view the prime component of nursing is caring for an individual, family and health worker in order to provide quality care in all aspect of health by maintaining both therapeutic relationship and standard of practice in working environment (Potter, Perry, Stockert, & Hall, 2016).

Defining nursing metaparadigm according to my belief, values and assumption

Nursing metaparadigm includes nursing, environment, person and health. Nursing can be defined as application of theoretical knowledge into practice by maintaining the professional standard at work to render a safe and high level care, in other words maintain a better therapeutic relationship with both patient, community and other team members, which helps in providing care for treating disease, promoting health and maintaining health standard of client as well as nurse (Potter et al., 2016).

According to me environment includes both internal and external factor that contributes to promotion as well as decline in health of a person, external environment can be physical, social factor, whereas internal environment includes psychological and physiological factors. (Jarrin, 2012)

Person is an individual, group, family or community, which are involved in period of caring in the healthcare setting as well in the society whether sick or well (Masters, 2015). In addition to this according to me person include both patient and nurse because fitness of nurse is also important to give better care (Potter et al., 2016)

Health comprises of the state of person in all aspects such as physical, mental, social, spiritual, emotional and economical. Every individual explain health according to their perception of environment, reaction to illness, ability to do care and acceptance of relationship with others (Potter et al., 2016).

My Nursing Philosophy and why it is important

Nursing as a profession do not follow one paradigm or theory in every situation because every health care worker have different belief, value and concept for caring a person. For me holistic care approach is vital component in caring for a person because I believe patient should be treated as whole in simple words treatment does not consider treating disease physically only but it should include promoting health by mental, spiritual and emotional concern of health. Holistic care also includes involvement of all health department in overall delivery of care to patient such as medical and Para medical department, counsellor, social worker, dietician as well as nurse. According to my point of view the main focus of holistic care is to help person in regaining its strength so that they can do activity of daily living. Moreover my nursing philosophy helps me to build therapeutic nurse client relationship throughout care without doing biasness on the basis of culture, caste and trade diversities or ability to do care among patients as a result it helps them to maintain their trust with health care worker, build their self esteem, dignity and helps in self guided improvement in them. This paradigm also includes betterment of health of caregiver as they also play a vital role in rendering quality care to the patient. (Jasemi, Valizadeh, Zamanzadeh, Keogh & Taleghani, 2017). Having a personal philosophy directs me in updating existing body of knowledge to deliver better care to person without being bias and to become a good member in healthcare team by maintaining standards of nursing.

Relationship of my nursing philosophy with practice

I would like to illustrate relationship in my nursing philosophy with practice by giving my personal life experience as an example, I was posted in post surgical unit during my internship period of bachelors degree and a patient was admitted in the ward her name was Mrs Rena, 38 years old, she was gone through with abdominal hysterectomy 4 days ago and she was complaining for severe pain, after consultation with physician intramuscular analgesic was given but after half hour she again started complaining, then with permission from my supervisor I tried to talk with her and I came to know that she was anxious about further recovery process and bodily changes, it helped me recall how mind affect body because the origin of pain was not physical though it was due to stress, so I gave her health education on the bodily changes and recovery process duration. I was able to main interpersonal relationship with her and she understood the whole concept that leaded to decrease in anxiety as well as pain level. So, I used holistic approach there because therapeutic communication is considered as treatment option now under holistic care and considering client as a whole is much more important because person’s perception of health and disease also affect there stages of recovery from any disorder or illness and if person’s self dignity and self esteem is maintained and the one is not only willing to do self care but want to improve health status then their health can improve in all aspects. And as nurse it is essential to be physically as well as mentally healthy to use all capability in caring for a person. (Jasemi et al., 2017).

Conclusion

To conclude my paper I would like to say nurse should consider concept of nursing metaparadigm while caring for a person and nurse should also maintain professional relationship environment with both patient/family and other healthcare team members to provide quality care.

REFRENCE

1. Jarrin, O.F. (2012). The Integrality of Situated Caring in Nursing and the Environment. Advance Nursing Science, 35(1), 14-24. doi: 10.1097/ANS.0b013e3182433b89
2. Jasemi, M., Valizadeh, L., Zamanzadeh, B., Keogh & Taleghani, F. (2017). Effective factor in providing holistic care. Indian Journal of Palliative Care, 21(2), 214-224.
3. doi: 10.4103/0973-1075.156506
4. Masters, K. (2015). Nursing theories: A framework for professional practice (2nd ed.). Retrieved from:
5. https://books.google.ca/books?id=sd0BAAAQBAJ&printsec=frontcover&dq=meta+paradigm+of+nursing&hl=en&sa=X&ved=0ahUKEwjI7NXc1LriAhWNgAKHddUCnYQ6AEIVjAI#v=onepage&q=meta%20paradigm%20of%20nursing&f=false
6. Potter, P. A., Perry, A.G., Stockert, P.A., & Hall, A.M. (2014). Fundamentals of nursing (9thed.). Retrieved from:
7. https://books.google.ca/books?id=eCKKCwAAQBAJ&printsec=frontcover&dq=fundamental+of+nursing&hl=en&sa=X&ved=0ahUKEwizz82KqLriAhXnx1kKHZ1bDmsQ6AEIMTAC#v=onepage&q=fundamental%20of%20nursing&f=false

My personal philosophy stems from the life values instilled in me as a child. These values consist of integrity, trustworthiness, connection, and compassion. From childhood, my passion has always been to care and make a positive impact in the lives of others. My personal philosophy is rooted in dignity, service, and evidence based practice. It focuses on the holistic wellness and empowerment of each patient while showing the upmost respect regardless of race, ethnicity, socioeconomic status, gender, sexual orientation, or life choices.

My personal definition of nursing is providing high quality selfless care for the patient with a goal of alleviating suffering and bettering one’s life. Nursing involves so much more than administering medication and caring out orders. Nursing to me is all about the relationship established with patient and understanding their perspective. Being a nurse means being a friend, ear to listen, a shoulder to cry on, and a patient advocate. Essential elements of nursing consist of compassion, maintaining dignity, alertness, attentiveness, competence, responsibility, and respect.

There is an age-old debate regarding if nursing is considered an art or a science. To me it is a beautiful blend of the two. I believe the science aspect comes from years of schooling and medical experience. The art aspect comes from the qualities, values, and beliefs from within the nurse.

Nursing is an art because one must possess the art of discernment, connecting with people, and gaining the trust of others in order to fully fulfil the role. One must possess the art of knowing when to speak up, when to be tough, and when to be sympathetic. The art of coming up with creative ways to uplift patients and families on the most difficult days of their lives. The art of being able to sense when something is wrong and anticipating needs. As a nurse, it is also essential that one masters the art of prioritization, time management and the art of being flexible in varied situations. In the nursing field, one is constantly iterating with diverse populations so the art of being self-reflective and aware of biases is important. Lastly with the nature of the job, the art of active listening, and effective communication between patients, families, and physicians is essential.

Just as much as nursing is an art, I believe it is equally a science. The human body is extremely complex, and a nurse must possess an understanding of anatomy, physiology, biology, chemistry, and psychology to safely deliver care. Nurses should be well versed with medical terms, procedures, medication dosages and side effects. They must also study and thoroughly understand symptoms and precautionary actions to be taken in regard to patient illness. As new research is continually being released, it is the responsibility of the nurse to be aware of the latest best nursing practices.

Health can be defined in numerous ways. In my opinion, the definition of health is more than merely the absence of illness or disease. It is a junction between total mental, spiritual, physical wellbeing and optimal functioning. In order to assist patients in achieving total health, I believe it is important that each patient should be treated as an individual and not a number. As a nurse practitioner, I do not want to be a part of an organization that values the number of patients seen over the quality of care provided

Every person has a different set of values, and experiences. As a provider, I do not believe in using a set treatment for every patient with similar symptoms. I want to develop a personal relationship with my patients in order to create a customized treatment plan that works best with the patient. Along with individualized care I also feel strongly about providing holistic care to each patient. When a patient presents to me with an issue, not only will I address the presenting issue, but I will also investigate the factors contributing to the presenting issue. These other contributing factors may include diet, lifestyle, stress and environment.

The environment in which a person is raised and currently inhabitants has a huge impact on a person’s health and the health of their family. According to The Office of Disease Prevention and Health Promotion (ODPHP), maintaining a healthy environment is central to increasing quality of life and years of healthy life. Globally, 23% of all deaths and 26% of deaths among children under age 5 are due to preventable environmental factors (2014). The World Health Organization (WHO), defines environment as all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviors (n.d). Many factors are to be considered when evaluating a person’s environment such as: are there good schools, are there good jobs in which people can make decent living, are there any grocery stores near, are there safe places to exercise, is it a stressful environment riddled with fast food restaurants and liqueur stores. The health inequities in America are known, and my passion is work in the underserved populations who do not have the same opportunities to be healthy due to the environment. I will work to provide resources and work with legislators to make a change. Because I believe that it is a basic American right for every citizen to have the same opportunities to be healthy and lead a productive life.

My view of person takes into count the mental, spiritual, and physical aspects of being. To be able to get to know each patient to this level requires dedication, and consistency. To think of the person fully, I believe you also must think of the role they play in their family. As a family nurse practitioner, not only am I to provide best care to the patient, but I am to care for the patient’s entire family.

In closing, as an advanced practice nurse, I vow to uphold the ethical standards of the American Nurses Association and my personal values by providing high quality safe care, and maintaining patient privacy and rights. I strive to be a patient advocate, educator, and role model for healthy health practices. I believe each patient should be treated individually and holistically. I consider it an honor and a privilege to be able to care for patients as a nurse and future provider. I will to continuous hold myself accountable to the standards I have set for myself in this paper.

The job I picked was a pediatric nurse practitioner and I picked this job because I wanted a job that worked with kids. When you are a pediatric nurse practitioner, you specialize in the care of newborns, infants, children, adolescents, and young adults. In this job you focus on primary care, growth and development, preventive care, and treat acute and chronic illnesses. They are limited on the medication they can prescribe because if they need a medication that they can prescribe they have to ask the pediatrician to prescribe it. I they need help they have the Physicians to ask for help or a second opinion. For this job you can work between 8-12 hours a day. On an average you will be treating 24 patients a day.

The education for this job is around 6-8 years. First you will need a bachelor’s degree in the science of nursing. After you will have to go through a program for 2-4 years to get your nurse practitioner degree. In this program you have a significant amount of coursework and clinical work. But before you get your NP degree, you have to prove to the state that you learned and obtained all the skills information needed. So you have to take the state-specific NP exam to get you degree.

After school, it’s not going to be that hard to find a job because the job outlook will go up 19% by 2020. There are about 240,700 jobs available in 2018. Some of the places you can get employed at are doctor’s offices, clinics, hospitals, surgical centers. Some of the places in the hospitals that needs PNP are the pediatric units like critical, neonatal, and the oncology units. You will work between 8-12 hours a day and have about 24 patients a day. Working as a PNP your salary is average $88,597 and highest salary is $143,000. pediatric nurse practitioners about $49 per hour and $1,974 per week. Some of the benefits are free housing, partial expense compensation, and range of opportunities. After getting enough experience that you feel comfortable, you can open your own practice.

You have to have certain qualities and skills to be able to succeed as a pediatric nurse practitioner. Some of the qualities you need are compassion, resourceful, multitasker, and detailed oriented. Some of the skills you need are strong communication, critical thinking, and the art of distraction. You use the quality of compassion and the skill of distraction mainly because you are working with children and you want them to be calm and feel safe. You need to be a multitasker because you have to keep the child occupied while doing the things you need to do. You also need to be detailed oriented so you will know if the child is lying that they are sick or to see the big picture of why they are hurt or scared to talk about what happened to them. Being a strong communicator is important because you are not just talking to the children, but also their parents that are worried about their child. Lastly you have to be resourceful and a critical thinker because you work in a hospital, clinic, pediatric critical unit, pediatric oncology unit or other places. and people are relying on you to figure out what’s wrong with them and save their life.

When you become a pediatric nurse practitioner there are a lot of different duties and responsibilities you have to do. Some of the duties you have to do are physicals, immunizations, developmental assessments, and well-child exams. The physicals can be for sports or school and the immunizations are for programs and school, so both of them are important for you to stay up to date with. The well – child exams and the development assessments are to check the child’s height, weight, vision, hearing, and other screenings. By doing these testings it helps you see if the child has developed problems. You also treat childhood illnesses like chicken pox and chronic illnesses like leukemia. If the child is sick, you can prescribe medication but there are limits and if it’s a medication you can’t prescribe you can ask a pediatrician. You can order lab tests and xrays to see what is wrong with the child. You will have to teach patients and families about what they can do to help themselves or the child. You can provide resources like teen birth control counseling and newborn and lactation education by becoming a liaison. If there are any problems with the child you are in charge of telling the family. You use basic equipment like a stethoscope, blood pressure cuff, heart monitor, pediatric pain scale, and a pocket guide. Some of the procedures you proform are suturing, starting IVs, giving medication, wound care, ear washing, and strep screenings.

In conclusion, I would choose this career right now because I like helping children. The biggest reason I would be a pediatric nurse practitioner and not a pediatrician is the schooling because if I become a PNP I don’t have to go to school as long but be able to help the children just as much. Another reason is I have a chance to have my own practice and be my own boss. The next reason is that I already have some of the qualities like compassion and resourceful because I will try my hardest to help the children and not give up when I don’t know what is wrong. If I go to college for this career I would go to is Brown University because it’s close to home and I don’t have to worry about dorm charges. It’s close enough that I can live at home. I also go to Brown a Saturday a month because I’m in a program there and I like it there.

Nurse Practitioner is a great occupation for me because it satisfies my personality, interests, and values. I took two personality tests and it told me what kind of work I enjoy and how am I as a person. To begin with, my personality type according to the 16 personalities Myers Briggs test, is INFJ-A. My character resulted in an advocate. They are the kind of people, if something is important to them, they go out of their way for it. Their passion for their goal is what gives them an Advocate personality. I also took a test on Naviance and my Holland code was ISA, which is, Investigate, Social and Artistic. They involve an extensive amount of thinking while helping or providing service to others and the work can be done without following a clear set of rules. Moreover, Nursing came up as a match in these assessments because I enjoy helping others. In this project, I will explore the career as a Nurse Practitioner, and contrast things like the job description, working conditions, educational requirements, and outlook, to my own expectations and goals.

A day for a Nurse Practitioner can vary depending on the situation they have to deal with. This means they have to make decisions according to their work conditions. Nurse Practitioner has duties on which, “They provide primary care to people of all ages, assessing, diagnosing, and treating common illnesses and injuries. Their interactions with patients have a strong emphasis on teaching and counseling for health maintenance. Nurse Practitioners recognize the importance of the social and emotional aspects of health care in addition to the more obvious physical factors”(Ferguson). They are expected to be able to do simple things like, analyze and interpret patient’s information to develop appropriate diagnoses to prescribe medication dosages. Also, they do more complicated tasks like complete blood counts, electrocardiograms, and radiographs or x-rays. The work environment depends on the Nurse Practitioner’s particular object of study. Many choose to work in rural places located in small and local clinics. While on the other hand, others work in bigger hospitals or nursing homes. Additionally, a large number of Nurse Practitioners work in a place with patients that are scared of interacting with healthcare providers. Overall, all of these workplaces require Nurse Practitioners to be mature and have a lot of patience. So, this shows that this is an excellent job for me as I have a lot of perseverance and do not get mad easily. I also like the idea of vast choices for workplaces, which matches my willingness to work in different environments.

It is not easy to become a Nurse Practitioner, it requires an intensive amount of school, which means a lot of work and dedication. High school is a great start for planning for a career in Nursing. One of the things students can do is, if their high schools have classes like anatomy and physiology and biology courses, they should really consider taking it. Besides these, classes that will strengthen the students communication skills is a great choice because nursing involves them to be very interactive with patients. There are a lot of classes some high school offer that is needed for college. Then, the next step is college. In order to become a Nurse Practitioner, they must first graduate from an accredited school of nursing. Then, depending on their preference, individuals are open to many different educational routes to pursue their career. Furthermore, states require Nurse Practitioners to have a license and they can obtain it by taking a test. Overall, the journey to becoming a Nurse Practitioner is a long process but in the end, it is worth it. So, I am going to be willing to make the effort to become a Nurse Practitioner, no matter how long that will take.

The salary for Nurse Practitioners is based on the level of education and the place they choose to work in. “Earnings for Nurse Practitioners begin at approximately $50,000 and can go up to $85,000 or more a year. Factors affecting earnings include the experience, education, responsibilities, and professional reputation of the individual. Other variables include the specific job and its geographic location”(Career One-Stop). Nurse Practitioners make a pretty good amount of money yearly, which really compliments the amount of work they have to do every day. The exact amount they make is determined by the experience they had or the places they choose to work at. Also, the future for Nurse Practitioners is great. There is expected to be a big growth for Nurses. This compliments me well because having a fair amount of money is one of my life values and the best part of this is that the need for Nurse Practitioners is rapidly growing throughout the year.

Through Naviance, I began searching up what colleges would satisfy my needs and wants. My top 3 choices for college were, Worcester Polytechnic Institute in Worcester, MA, the University of Vermont in Burlington, VT and University of California-Santa Barbara in Santa Barbara, CA. I personally want to go to the University of Vermont because it is located really close to my home. I want to be able to attend college but at the same time not be far away from my family. Another thing that I like about this college is that it is located in a fairly small city. However, the tuition and fee is $47, 988 and room and board is $14,218. This can be a little too much for me, but I will not let this prevent me from going to this college.

After researching this career as a Nurse Practitioner thoroughly, I have come to the decision that it is perfect for me. The job description had many things that will help and improve and fit my strengths. The training requirements and the working conditions compliment my characteristics, as well as my values in life. The salary and job growth will fulfill the lifestyle I want to live.

Therefore, I will work hard and take any opportunities I can to move one step closer to this career.

Both professions require a high level of education. Similarly, both professions require a 3-year undergraduate degree, there are various routes to get to this goal. Higher National Certificate courses are available at selected colleges, however, as told by NHS careers (2020) applicants can apply to health or science-based subject to become a paramedic but states that nursing applicants may apply only to a healthcare practice course. The Scottish Widening Access Programme is for adult learners who have virtually no qualifications, a vital stepping stone enabling their path to university. Apprenticeships are offered, these vary slightly. A nursing applicant can apply to a modern apprenticeship in a healthcare support role, whereas a paramedic has the opportunity to apply for a foundation apprenticeship, which will enable skills and work experience to be expanded as told by NHS careers (2020).

Nursing and Paramedic graduates both have to register with their regulatory bodies. An adult nurse must register with the Nursing and Midwifery Council (NMC) and paramedics must register with the Health and Care Professional Council (HCPC) both regulatory bodies are very similar with slight differences. Registering with the NMC a registration fee of £120 and a declaration must be signed and paid. The registration of a paramedic is very similar, but the HCPC (2018) confirms a new graduate registration is £90, so differing from the NMC. Both professions have to meet standards to register, paramedics with ‘standards of proficiency’ (HCPC, 2014) nurses with ‘The code’ (NMC, 2018).

Revalidation defined by the royal college of nursing (2020) is the process required every 3 years to continue to practice as a registered nurse. Revalidation encourages an environment for self-reflection, sharing, and personal growth. There are certain requirements to be met, for example, NMC (2019) requires 450 practice hours, 35 hours of CPD including 20 hours of participatory learning, etc. Continuing Professional Development (CPD) is defined by The CPD Certification Service (2020) as the term used to describe the learning activities professionals engage in to develop and strengthen their abilities. Nurses have to revalidate every 3 years whereas a paramedic renews every 2 years. While a nurse has to complete additional requirements such as a reflective discussion, a paramedic keeps a continuous CPD profile, which involves learning activities that are most relevant to a paramedics practice, The College of Paramedics (2019) aims to support and further professional development. As per HCPC (2018), a CPD audit is a part of the renewal process for a paramedic, only 2.5% of registrants will be asked to submit their profile, this differs from the renewal process for a nurse.

A code of conduct is very important for both professions as it ensures each professional adheres to the values and principles set out. The HCPC (2018) explains that the professional is solely liable for their actions. A nurse must adhere to The Code and paramedics must adhere to the Standards of Proficiency. Both are very similar, per the NMC (2018) there are four categories that a nurse must adhere to when practicing – Prioritise people, Practice effectively, Promote professionalism and trust, and to Preserve safety. Although one difference is that the HCPC (2014) lays out 15 categories as opposed to the 4 categories within ‘The Code’. The similarities for both professions are to practice effectively and promote professionalism and trust. What differs is a paramedic must practice as an autonomous professional, autonomous being defined by the Cambridge Dictionary (2020) as being independent and having sole power when making decisions. So, with the HCPC (2014) an individual must be able to make informed, reasoned decisions about their practice and rationalise any decision if asked to. The standards are not set to catch any individual out, it is the opposite they are there to relate elements of their practice to. Professional boundaries are necessary when practicing as a nurse or indeed a paramedic. With regards to the Standards of conduct, performance, and ethics from the HCPC (2016) they state that paramedics must maintain appropriate boundaries, and to use social media responsibly. The Code, NMC (2018) is very similar as they state that a nurse should uphold professional boundaries with current and past patients. NCSBN (2018) defines professional boundaries as the space between a nurse’s power and the patient’s vulnerability, also relatable to a paramedic. Similarly, both codes reference the use of social media, this is a big factor in maintaining professional boundaries. It would be deemed unprofessional to befriend any patient past or present, or to discuss patients online as this could potentially jeopardise a patient’s safety. Business Dictionary (2020) defines ethical behaviour as showing honesty, fairness, equality, dignity, diversity, and individual rights. There are few differences and a lot of similarities with regards to ethical behaviour, as previously stated both, the standards of conduct, performance and ethics, and The Code stress the importance of upholding honesty and dignity with regards to the wellbeing and treatment of a patient. Ellis (2020) states that the failure to understand ethical decision making may lead to putting not only themselves but the patient in danger. This is very important as it makes both professionals stop and think about the potential repercussions of any decision they make. Ethics can be argued back and forth as a patient does have the right to refuse any kind of care or treatment and Law Teacher (2019) argues that no paramedic nor nurse can take that away from a patient. However, the patient’s wish can be overturned if they are deemed incapable to make such a decision. A paramedic could justify overturning a patient’s decision by referring to HCPC (2016) identifying and minimising risk, assessing the situation properly, and having taken all reasonable steps, therefore reducing the possibility of harm towards both the paramedic and the patient. A nurse treating a patient in this situation can refer to The NMC (2018) in particular protecting the best interest of people at all times by keeping to the relevant law about the mental capacity to ensure the rights and best interest of a patient are still at the centre of the decision making process.

Both a nurse and paramedic have huge levels of responsibility, they need to be accountable for their decisions. There isn’t much that differs, they both provide a high level of care and respond to a patient’s physical and emotional needs. However, NHS Scotland Careers (2020) tells us that a paramedic will provide an immediate response to accidents and medical emergencies. The main difference is that a paramedic will be the first to assess and care for the patient, a nurse will then continue to monitor, assess as told by NHS Scotland Careers (2020). Both would be held accountable if any of the decisions they made regarding the patient caused any kind of trauma. Per the NMC (2018) if a task is delegated to another member of staff the nurse must ensure this is within their scope of practice and the instruction is fully understood. A nurse could be deemed incompetent and negligent if passing on tasks and not ensuring that patient safety and well-being are secured. There is no difference in this aspect as the HCPC (2016) states that a paramedic must always delegate responsibilities appropriately and could face possible discipline if this is not adhered to. Griffith (2015) states that accountability underpins the professionalism, integrity, and probity of practice. Clinical supervision allows for a better working environment for the nurse/paramedic which ultimately will reflect on the care of the patient. College of Nursing (2020) describes clinical supervision as a way to promote critical reflection, development needs, and supporting revalidation. Unlike with nursing, where a student nurse on placement will have a mentor or a qualified nurse will have the nurse in charge to, turn to offload any emotional difficulties. A paramedic does not have as great access to professional supervision as a nurse, as argued by Ellis (2013) this was slower to develop within the paramedic community. The need for supervision for a paramedic will change as they develop throughout their career. Ultimately professional supervision is important for both careers as it allows for a channel of communication and ultimately a way to constantly improve practice. As both a nurse and paramedic have to meet the standards of their own code, a key factor to this is having to refer a colleague to a professional who outranks them or their regulatory body. Referring a colleague for a misdemeanour could be due to them exploiting the vulnerability of a patient, which could cause anyone to cause harm as they now know confidential information, and this is an immense breach of all codes of conduct. Both the NMC and the HCPC recommend that an issue be taken up with the colleague in question directly or with management as the HCPC (2018) confirms that this is usually the most effective method of resolving a complaint. Maintaining patient safety is a huge similarity for a nurse and paramedic, and to keep within their scope of practice. A difference is a paramedic practicing as an autonomous professional HCPC (2014) upon assessing and determining the initial treatment plan for a patient, identify when they do not possess such knowledge and refer to a more superior experienced colleague for help to ensure patient safety is not jeopardised. A nurse is not classed as an autonomous professional which differs however, there are similarities as like a paramedic and following the NMC (2018) help must always be offered if they see an emergency arising, taking account of their own ability and seeking the availability of other options for providing care to avoid putting anyone’s life at risk.

Ultimately there are far more similarities than differences upon comparing and contrasting adult nursing and paramedics.

Role of a Nurse

The nurse takes part in a major role in the medical field. A patient suffers desolate and irritated at the moment of disease or any treatment. At the moment, the nurse goes about as a friend to the patient. The nurse gives the most ideal consideration for them. Additionally, the patients get psychological help, which causes them to get well soon. Nurse ought to urge families to participate in exercise they appreciate and strengthen the medical advantages of continued physical activity to improve the probability that way of life changes will be clung to and co-morbidities prohibited. Such as picking a movement the family appreciates, for example, moving, dancing, field sports, or family walks builds the opportunity of them persevering with it. Joining exercise into everyday schedules, for example, strolling to school or cycling to the shops can make it simpler for families to keep up a level of action. Nurses can assist the guardian and children by giving nutritional counsel. Each nurse should have what it takes to examine evaluation and review various circumstances in the medicinal field. It might be a crisis or an abrupt loss. They need to take exact and appropriate activities thinking about the occurrence. They can’t get irritated and lose temper since it can bring about serious circumstances. Consistently is diverse in this field, as are the decisions and choices.

A decent instructive foundation is basic for a person to turn into a nurse, however, alongside this; each nurse must have some great characteristics.

Changes to nursing since 2000

As nursing started it had almost no to do with official medicinal preparing as well as all to do through your gender and readiness to carry out the responsibility. At the beginning of nursing, ladies took in restorative aptitudes from their moms or other ladies in a similar calling. It wasn’t generally observed as a regarded exchange; however, ladies weren’t generally observed as decent trade, either. Ladies were overseers, so nursing was only an augmentation of what their jobs at home were at any rate. Today, nursing calling has changed radically. There are broad preparing programs, progressively enhanced staff, and a degree of renown related to this territory of the medicinal field that wasn’t there previously.

Time has finished a great deal used for some professional ways, however, the nursing field has perceived uncommon transformation to help the effectiveness of medicinal consideration. There is all the more preparing projects, better emergency clinics, greater obligation, a feeling of family, and an attention on persistent consideration in the treatment business that has spared lives and made ages of devoted medicinal experts.

Patient care is presently a serious factor in the health field for every medicinal expert. The headways in innovation have made a situation that makes quiet consideration increasingly productive and supportive for the patient. Mechanical headways have changed pretty much every industry in the US and the health field is the same. This has helped spare more lives, made certain employments simpler for nurses, and made a superior encounter for patients. The way of life for quiet consideration used to be a disheartening encounter for some patients where medicinal experts weren’t as worried about their pride or suffering difficult medicinal techniques. Fortunately, quiet consideration has become the main need for medicinal experts and has thrived as of late with attendants on the bleeding edges of patient consideration.

The nursing calling has come to a far cry and keeps on being a developing field. Truly, it has demonstrated its capacity to adjust to the way of life around it. For nurses and patients the same, the advances made have helped the nursing field to go from being one that isn’t loved as being one that earns admiration. The adjustments in preparing, human services setting, developing obligations, nursing society, and patient consideration have spared incalculable lives and helped it become the regarded field that it is today.

Skills of a Nurse

Nurses, who deal throughout the everyday plan of the patients, are mainly basic element of the hospital. They are the health care provider, who look at & help out the patients. They additionally go about as an arbiter among the specialist and the patient’s family. These experts offer awareness about the patient’s disorder, cure and the doctor’s directions to the relatives. A nurse has the accompanying aptitudes.

Each nurse can be given numerous patients to take care of at once, so it is better if the nurse stays arranged for bearing each of the obligations. Nurses need to deal among each sort of feeling of the patients, similar to outrage, disappointment, torment, and misery. In such circumstances, it is significant and essential that each nurse tries to stay cool and know the conditions. A proficient nurse must be considerate, thoughtful, non-critical and ought to be able to give solace to the patient both genuinely and intellectually. A nurse ought to likewise be a good listener, and the discussion must be delicate and polite. Nurse with awareness of various dialects is commonly paid higher. The nurses must be very agile, centered and detail-oriented. They set up the patient’s reports and give medicines. A small mistake can ruin someone’s life. In this field, even a minor detail holds extraordinary significance and hugeness.

As nurses increase clinical awareness, a great experience & continue further instruction, they turn into ready to perceive the issues of a patient on their own. Nurses must be able to acquire self-sufficiency through basic reasoning which encourages them to adjust as indicated by the changes. The basic thinking is a main characteristic that encourages nurses to pass judgment on the circumstances and take accurate choices.

Job Specifications

Nurses work as a major aspect of a Nurse’s need to deal with each sort of feeling of the patients, similar to outrage, disappointment, torment, and misery. In such circumstances, it is significant and essential that each nurse tries to stay cool and comprehend the conditions.Group of experts and medicinal personnel incorporates specialists, doctors, surgeons, social workers, and therapists.

Ordinary job specifications include:

• Evaluating and arranging nursing care necessities
• Giving pre-and post-activity care
• Observing and overseeing drug and intravenous imbuement’s
• Taking patient samples, heartbeats, temperatures, and blood pressures
• Setting up accounts
• Administering junior staff
• Sorting out remaining tasks at hand
• Giving passionate help to patients and family members
• Coaching understudy medical caretakers
• 24-hour move work can be a prerequisite of the activity

Differences in nursing from 1900 to 2000

When we take a look back to the nurses of the 1900’s we see many cases in our history where the decisions on the back of the doctor or maybe against the doctors are taken by nurses of that time. If the decision leads to successful outcomes. Everyone praised the nurses but if the outcome is in failure everybody blamed the doctor. But when we take a look at the nurses of the 2000’s they are more trained and educated. They have to follow the rules and policies of the hospitals. They are not allowed to interfere with the doctor’s decision. And plays more in the treatment of any patient. As a nurse in kind and heartily words is a metaphor of motherly affection and consistent women.

What impact has university training had on the skill of a nurse?

The main role of training is to improve and polish the skills of the nurses of today’s era. Even if they know things but still training let them know how it feels when the gained knowledge is applied practically in training. Training makes your skills more robust against the stresses and strains they face. All evidence points to the importance of training people, and nowhere do we see an invitation for the opportunity to downgrade the nursing workforce.

Other than the differences in mortality rates, there must be some possible outcomes of deficits in soft skills. As the hospital is a place to which people visit in their emergency or in times of absolute crisis. Any event either positive or negative can make huge differences among people.

The exigencies of modern healthcare mean that actually, very decent people are sometimes unable to deploy their basic human nature in the face of appalling pressures.

NHS (National Health Service)

The individual healthcare service providers units in England, Wales, Scotland and Northern Ireland collectively in United Kingdom are known as NHS. It includes NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland. They were established together in 1948 as one of the major social reforms following the Second World War.

Aging Population

A number of people who ranged between the age of 65 and 80 are predicted to increase by 53% from 2001 to 2031. So in the upcoming years, the number of aged people will increase so the workload and the final pressure on NHS will be more. We examined the possible impact of the aging population on the expected number of people with three cardiovascular disorders: coronary heart disease, heart failure, and atrial fibrillation.

Growth of digital technology

We’re using technology to help health and care professionals communicate better and enable people to access the care they need quickly and easily when it suits them.

From websites and apps that make care and advice easy to access wherever you are, to connected computer systems that give staff the test results, history and evidence they need to make the best decisions for patients, we’re working smarter to provide better care than ever before.

The NHS Long Term Plan was published on 7 January 2019. The plan sets out our ambitions for improvement over the next decade, following the five-year funding settlement announced by the government in July 2018. The plan underpins the importance of technology in the future NHS; setting out the critical priorities that will support digital transformation and provide a step-change in the way the NHS cares for citizens.

As of 1 July 2019, NHSX, which brings teams from the Department of Health and Social Care, NHS England and NHS Improvement together into one unit, is responsible for driving digital transformation and leading policy, implementation and change in this area.

Funding and Finance

The NHS is funded mainly from general taxation supplemented by National Insurance contributions (NICs). The level of NHS funding in a given year is set by the central government through the Spending Review process. This process estimates how much income the NHS will receive from sources such as user charges, National Insurance, and general taxation. If National Insurance or patient charges raise less funding for the NHS than originally estimated, funds from general taxation are used to ensure the NHS receives the level of funding it was originally allocated.

Policies and regulations

• Corporate governance documents
• Governance documents
• Information Governance documents
• Freedom of Information Publication Scheme
• Safeguarding
• Equality
• Complaints and other customer service policies and procedures

Class and Ethnicity

Class analysis and Ethnic Studies both have an evolving history. It is the brand and the local market in the context of people. This lead to many in part to inherent conflicts between the two cases. We have occasionally seen reactionary forces opposing class consciousness while striving to develop ethnic consciousness.

Conclusion

In summary, the jobs of the nurse agitate the arrangement of new points of view. The responsibilities range from easy to difficult obligations. They incorporate performing physical assessments, the advancement of wellbeing through refinement, organization of prescription and individualized consideration. Additionally, directing examination, understanding of patient data, and basic leadership are the center obligations that mix new viewpoints that are acclimatized into the nursing collection of information. The nurse that accomplished an elevated level of independence and accomplishment were improved set in present persistent fulfillment administrations. Alternately, nurse expertise blend and recruitment levels wreck persistent wellbeing results in case of insufficient clinic supplies and hardware.

References

1. https://minoritynurse.com/how-nursing-has-changed-over-time/
2. https://www.topregisterednurse.com/registered-nurse-skills/
3. https://en.wikipedia.org/wiki/Childhood_obesity
4. https://www.nytimes.com/2000/11/07/health/becoming-a-nurse-two-views-1900-and-2000.html
5. https://connects.soton.ac.uk/feature/the-importance-of-training-in-nursing-healthcare/
6. https://en.wikipedia.org/wiki/National_Health_Service
7. https://www.bmj.com/content/331/7529/1362.short
8. https://www.england.nhs.uk/digitaltechnology/
9. https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/how-nhs-funded
10. https://www.england.nhs.uk/contact-us/pub-scheme/pol-proc/
11. https://www.marxists.org/history/erol/ncm-1a/hus-class-ethnicity.htm