Category: Nursing

Florence Nightingale (1820-1910) was an outstanding human and left the priceless legacy for future nurses. She devoted her life to globally raising awareness of health issues and successfully transferred her message: widespread nursing care is essential for reaching local-to-global health (Beck, Dossey, & Rushton, 2012). Nightingale made a great contribution to global development, and later her principles were reflected in eight UN Millennium Development Goals, aimed at creating high quality of life (United Nations Millennium Development Goals, 2000).

Florence Nightingales Influence on my Perception of the Millennium Goals

The legacy left by Nightingale cannot be neglected. She was the founder of modern nursing, and I cannot deny that her work makes an impression. I was aware of the UN Millennium Goals and that three of them are directly linked to healthcare. However, I could not imagine that so many years ago someone could be smart and brave enough to start fighting global health issues. I completely agree with the authors of Florence Nightingale. Connecting Her Legacy With Local-to-Global Health Today who stressed that her work has direct application today  local and global  in the acute care environment and in community settings worldwide (par. 5).

This massive impact of Nightingale on my perception of the Millennium Goals is also connected with my thoughts concerning global issues in general. Despite the fact that humanity made a huge leap in its development, it seems that the agenda remains to be almost the same. The system is still lacking highly-qualified nurses, who would be able not only to assist in care but also educate others to prevent future diseases.

Three Goals to Advance

As a nurse, I would focus on the following goals for global development: reduction of child mortality, improvement of maternal health, and fight against HIV/AIDS and other diseases.

High level of child mortality has a number of causes: pneumonia, malaria, neonatal causes and others. The goal for nurses would be to prevent such cases through right care, proper feeding, and vaccines made on time.

Improve maternal health concerns taking care of future and present mothers. The process of childbirth can have negative consequences for womens health and pregnancy is always risky. Nurses are supposed to do their best to avoid complications of pregnancy. In general, they are one the most important mediators in this process and can significantly help women in coping with the challenge.

Combat HIV/AIDS is an issue which is getting more and more attention, as the number of the diseased is increasing gradually. Nurses can be providers of basic knowledge for all patients. In this case, only knowledge can prevent future sickness.

How We Can Help Advance the UN Goals

The real shortage of educated nurses in the healthcare system has been a problem for years and unfortunately, still exists. It puts pressure on those who already work. Hence, the solution might be in further promotion of nursing as a decent job. Nightingales mission should be continued, as only well-educated nurses can help advance healthcare and UN goals.

As for common combat against diseases, our community of nurses could contribute to the improvement of the environment through workshops and seminars. Spreading knowledge has never been useless, and massive education on health topics could raise public awareness and make the society noticeably healthier.

To sum up, Nightingales impact on the nursing and healthcare system made a huge contribution to the worlds development. Up to now, her legacy remains important for everyone who works to create high quality of living and wants to positively change the lives of all nations. UN members develop strategies to reach those high standards, and success would be impossible without such purposeful activists like Nightingale.

References

Beck, D. M., Dossey, B., & Rushton, C. H. (2012). Florence Nightingale. Connecting Her Legacy With Local-to-Global Health Today. Web.

United Nations Millennium Development Goals. (n.d.). Web.

Introduction

This paper was about a very interesting article published in the month of June 2006 by the Journal of Nursing Standards, an internationally recognized journal dealing with the latest development in nursing and medical science. Its authors are Cole, Lynch and Cugnoni. Elaine Cole is a lecturer on nursing at the City University and a practitioner at the Accident and Emergency (A&E)/Trauma and the London NHS Trust. Antonia Lynch is a consultant nurse working for the A & E. Helen Cugnoni is a consultant in emergency medicine working at Barts and the London NHS Trust.

The main topic of the article is to become a sort of manual for nurses working on Accidents and Emergency around the country when they deal with adult patients who present themselves with acute abdominal pain. The article tends to describe how to assess their pain, manage it and offer possible solutions.

Summary of the article

The authors begin their paper study by assessing the importance of the problem. Being the three of them practitioners and with a clinical background, they assess the confusion and bad management that sometimes arises in emergency departments due to the lack of proper identification from the nurses of the type and origin of abdominal pain that the patients have. This is the focus of their article.

In order to avoid such confusion and mismanagement / mistreatment they propose a health assessment procedure that each nurse should follow to properly diagnose their adults patients. It should be stated that their focus population in this article are older adults, especially males. The authors clarify this focus by presenting the data that this population group has been the most presenting to emergency and accident divisions with abdominal pain.

Back to the health assessment procedure. The authors argue that a structured approach to history taking and pain assessment, nurses should be able to differentiate abdominal pain caused by acute rather than non-acute conditions (Cole et al, 2006). The basic reason underlying this assessment is that within a contemporary, intra-professional healthcare environment, it will help increase the chances of a fast and as effective as possible treatment. From this framework we can deduce the tools the authors propose the nurses should use. History taking is the first and most important one. Accurate history taking is crucial for this process. Since a nurse is most probably the first healthcare professional that such patients encounter, it is also the closest to the event that might have caused the pain. That is why accurate history taking is essential. The nurse should be careful to respect all aspects of a professional history taking process taking into consideration the privacy and other personal rights of a patient.

After that, the nurse should make a physical assessment of the pain. That is the second tool. This should not be done in hurry but all the procedure should be followed accurately. The third tool for a nurse is the psychological assessment of the patients. Since abdominal pains are quite complex and might have many causes, psychological factors should not be underestimated. Many times they are determinant to the condition of the patient (Cole et al, 2006).

Evaluation of the article

The article was of much interest as it deals with an important problem relating to the profession of nursing. It is also important because it deals with patients in emergency needs and a mistake in such conditions may affect the patients entire health recovery. What was done extremely well in this article was the broad explanation of the causes of abdominal pain. This makes the article a must for each nurse dealing with such patients. The anatomy and physiology of the disease is important to assess its origin and this was done very well from the authors. Another important contribution of this article is the account of various situations that nurses might encounter. Being practitioners who serve on emergency units, the authors have made a quite impressive description of the situations that a nurse can encounter and how to deal with them. The third thing done well was the framework and tools provided for the nurse to properly hand such situations with adults with acute abdominal pains. This is a very beneficial health assessment strategy which could easily be put into practice. This easiness comes from the fact that it was described in details.

Nevertheless, there are certain critical points that should be made about this paper. First of all, the authors could have easily expanded the targeted population not only confined to older adults but to include other groups as well. Another critique is related to the psychological factors influencing the patients. Since most of them come after an accident of any type, they may still be in a state of shock or trauma. This makes it difficult to pull out an accurate health history from them at such moments. The authors should have provided some kind of tool for the nurses to dig through the trauma.

Conclusion

This was an article published in the journal of Nursing Standards on June 2006 by three prominent authors. Their aim was to demonstrate the state of affairs in Accident and Emergency divisions around the country relating to patients who present themselves with abdominal pain. They demonstrate in the article the important role of nurses when making the first assessment of their patients and the problem arising with such situation. In order to avoid confusion and have the best possible assessment of the health status of the patients, they propose a certain framework and tools that will help nurse properly diagnose these adults. It was an interesting article with a very good proposal which might have a positive impact in applied on the field and turned into a sort of manual for nurses in emergency departments. Especially the application of the tools that the authors propose will benefit the nurse during their daily work.

References

Cole, E. Lynch, A. and Cugnoni, H. (2006) Assessment of the patient with acute abdominal pain. Nursing Standard. Vol. 20, Issue 39, pg. 67-75.

Brief description of the encounter I had with a client

In general, communication, especially the first contact with a patient, is essential; it determines the patients different relationship with the medical staff. In the context of the treatment process, the nurse acts as a partner, an intermediary between the patient and the treating physician. It is essential to establish a relationship of trust, so the nurse must make the patient feel at home. This situation happened in a day service center for people with intellectual disabilities where I was presented as a student nurse during my medical internship.

In my first days on the job, a woman in her sixties and her son in his thirties came to my first appointment. The young man explained that his mother had an intellectual disability due to progressive Alzheimers syndrome. Although the situation was complicated because the patient could not assess the situation soberly and thoroughly, so all communication mainly occurred with her son, the patient actively wanted to participate in the admission process. That is why I had to repeat the same information several times trying to avoid its mixing. This approach slightly impacted my efforts to build solid relationships between me and a patient on the basis of compassion, respect, and mutual trust.

What was my role in the encounter?

My role in this appointment was to provide an initial examination and admit the patient to the hospital.

Did I feel comfortable or uncomfortable? Why?

I felt a little uncomfortable with this situation as I had to switch my attention between the patient and her son constantly repeating the same information making sure it was not mixed or missed. This situation created tension and I was afraid to spoil relationship with my patient and her relative due to any error or negative emotions.

How did I convey or not convey my understanding to this client?

I had to use some patient communication skills, such as tolerance, respectful communication, and listening skills. I explained to the patient through phrases that showed my interest and involvement in the patients story. I also spoke in as friendly a tone of voice as possible and let the patients son know that I would understand and take as long as necessary to explain the essential information.

Were listening skills appropriate?

Communication is essential in a nurses work. Even if a nurse is naturally communicative, it is vital that she can analyze her contact with people and consciously use her skills to improve her professional performance. To reflect on this experience, it is necessary to evaluate my listening skills. I believe that my listening skills were appropriate to provide decent service to my patient and her son. The foundation of my communication for relationship building was participation, openness, listening, perception, concern, acceptance of others views, empathy, sincerity, and respect for the other person. In doing so, I also exhibited active listening skills. During the meeting, I asked follow-up questions and showed my interest in helping the patient. I feel that I could not have demonstrated better listening skills than I did in the meeting because I did everything I could to make the patient and her son feel comfortable.

How could I have improved my listening skills in this encounter?

I could learn a lot of helpful information from theoretical studies in psychology and nursing to improve my listening skills to convey understanding. For example, listening skills mean being open to the world, to the thoughts and feelings of others, explicitly expressed or implied. Listening skills require sensory understanding and refraining from making judgments about the other person. It does not involve influencing another person to change them or trying to do so. Listening skill is an active, conscious effort to form participation, not mere passive perception (Bramhall, 2014). It requires concentration, an absence of bias, and an interest in what is being said, in addition to a very understanding of what is being said. My experience during the meeting influenced my view of listening to convey understanding. I realized that I needed to focus more on the patient rather than the companion. The patient is the central figure of the appointment, and he should feel comfortable knowing that the nurse understands and accepts him.

What knowledge from theory and research (nursing and psychology) could I draw from in future to help me become more effective?

This encounter may be regarded as a stage of orientation according to Peplaus theory of nursing as an interpersonal and therapeutic process. In general, it identifies three stages of the nursing process: orientation, working, and termination (Hagerty et al., 2017). Orientation may be regarded as the most important phase as it presupposes the formation of contact between a patient and a health care provider. From this situation, I have received an opportunity to learn more about orientation and practice it to improve my professional skills for the future. Any patient should be identified as a person with his or her unique preferences, priorities, and needs that should be considered (Hagerty et al., 2017). In addition, respect, courtesy, and positive interest to a patient should be kept through all stages of the nursing process.

How has my experience of the encounter changed my way of thinking about listening and to convey understanding to clients?

From the experience of this meeting, I learned a lot of new information about my behavior in an unusual situation as a future nurse. This meeting was unique for several reasons. Firstly, it was my first experience of communicating with a patient and her relative at the same time. Such a meeting involves the ability to correctly distribute attention so as not to leave any of the visitors unnoticed. Secondly, the patient could not fully explain her problems and needs, and her son did it for her. This created difficulties in the sense that no one except the patient knows for sure about his experiences, even his relatives. Therefore, it was essential to ask the patients son many clarifying questions to make sure that he was precisely thoroughly familiar with the situation. Sometimes children send their parents to help centers for people with intellectual disabilities without knowing exactly what disease they suffer from. This can have unpleasant consequences; for example, the patient may be assigned to the wrong department and not receive appropriate care for her illness.

Myself (my thinking, feelings and behaviour)

From this experience, I learned that I have a high concentration and pay equal attention to both visitors at once. In addition, I successfully apply communication skills to find out all the details about the patient that interest me. I was also surprised by the fact that in such an ambiguous situation, I did not feel confused or disoriented. This suggests that I can cope with stressful situations and successfully hold meetings even in unusual conditions for me.

My communication skills

This meeting also gave me the opportunity to assess my communication skills objectively. The primary skill I showed was active listening. I have successfully applied verbal and non-verbal attributes of active listening, such as specific phrases and gestures that show my understanding and involvement in the patients situation. I also managed to convey to the patients son that I am entirely on his side and believe his words about his mother. This provided my visitors with comfort during the meeting and collected the maximum amount of helpful information.

My knowledge understanding and application of psychological/ nursing knowledge to practice (verbal and non-verbal listening skills)

During this meeting, I also had the opportunity to demonstrate my knowledge of nursing psychology and its application. For example, I know that sincerity is an essential aspect of communicating with patients. Sincerity is a necessary condition for establishing a relationship of trust. Sincerity means that a person honestly shares his thoughts, feelings, and experiences (McKenna et al., 2020, p. 612). A sincere or harmonious person understands his inner feelings and thoughts and correctly expresses them verbally and in another form. This harmony is essential for meaningful communication. It contributes to the emergence and maintenance of trust in oneself and between oneself and others (Myers, 2020). This trust gradually develops into free and open communication. Therefore, I showed maximum sincerity in communicating with patients. For example, I explained to the patients son that his mother has a progressive disease that cannot be treated. It can be fixed and slowed down to the maximum, but it cannot be reversed by freedom.

This policy of frankness helped me to build a trusting relationship with the patients son and, therefore, with her. If the patients family trusts the nurse, then the patient himself feels more confident. The experience of receiving this patient and her son also showed me the communication skills that I need to improve. Among such skills is increased focus on the patient herself and not on her attendants. I need to focus more on the patient, even if he cannot fully explain his condition. The fact is that even the behavior of a patient who is in his thoughts and some sense disconnected from reality because of his illness can say a lot about his needs. That is why it is essential that the nurse considers all the signs that the patient gives and puts the information received from the patient at the forefront.

What knowledge and skills do I need to work on to further improve my communication skills for nursing?

First of all, I should improve my ability to analyze the situation to understand what communication method will be the most appropriate one. In some cases, active involvement in communication is more efficient, while in others, careful listening is necessary. In addition, I need to improve my confidence to know that my communication skills are suitable for nursing practice. Concerning this encounter, I felt that my actions could cause a patients dissatisfaction, however, in reality, I did my best and succeeded. Moreover, the improvement of my emotional stability will help me to control my emotions. In nursing, this personal quality is essential  all patients have unique needs and different communications skills, and a considerable number of them are affected by health-related issues that cause stress and anxiety. Thus, my emotional intelligence will help to establish comfortable relationships with any patient.

What was my overall learning from engaging in this reflective project?

Summing up, from participating in this reflection project, I have learned a lot of helpful information and knowledge. First of all, thanks to this project, I was able to analyze my experience to become better professionally in the future. I believe that such reflection is critical, especially for medical personnel who practice direct communication with people. Secondly, the experience of participating in a reflection project helped me analyze my main mistakes in an unusual situation for me to communicate with patients. This was important to me because initially, I considered my behavior to be as correct as possible in that situation. Now, I was able to evaluate my communication with the patient and her son more objectively and notice some shortcomings on my part. Thus, writing a reflection project gave me invaluable experience analyzing my behavior in a client situation. From now on, I will reflect on my experience more often because I find this procedure very useful and necessary for practicing nurses.

Reference List

Bramhall, E. (2014) Effective communication skills in nursing practice, Nursing Standard, 29(14), pp. 53-59.

Hagerty, T. A., Samuels, W., Norcini-Pala, A., and Gigliotti, E. (2017) Peplaus theory of interpersonal relations: an alternate factor structure for patient experience data? Nursing Science Quarterly, 30(2), pp. 60-167.

McKenna, L., Brown, T., Williams, B., and Lau, R. (2020) Empathic and listening styles of first year undergraduate nursing students: A cross-sectional study, Journal of Professional Nursing, 36(1), pp. 611-615.

Myers, S. (2000) Empathic listening: Reports on the experience of being heard, Journal of Humanistic Psychology, 40(2), 148-173.

Professional nurses are responsible for taking care of individuals, families, and are qualified for developing an optimal care plan with the assistance of other medical personnel, such as physicians. The primary goal of nurses is to provide patients with necessary health assistance to improve the quality of their lives (Fahlberg & Toomey, 2016). The notion of serving in nursing is mainly associated with helping individuals and communities achieve their health goals.

For instance, nurses are the most significant actors when it comes to comprehensive care  they support patients throughout their journey in a hospital setting, identifying their needs, and informing doctors of implications (Best, 2020). Nurses serve by providing patients with all-encompassing care; first, they conduct an assessment of patients wellbeing by considering their social, economic, physiological data (Fahlberg & Toomey, 2016). Then, they form a diagnosis by examining symptoms and other factors, develop a plan of recovery, implement that plan, and evaluate the efficacy of performed interventions.

Since nursing does not represent only a single function, the notion of serving is different based on various environments. For instance, in hospital settings, nurses help diagnose patients conditions, help develop a care plan and assist patients with navigating themselves through their healthcare venture (Fahlberg & Toomey, 2016). In managerial positions, nurses serve by providing other medical personnel with favorable working conditions (Best, 2020). The nature of service depends on the type of nurse, where they works, and what functions they perform.

Although nursing is tightly associated with serving others, it does not yet fully align with the notion of servant leadership. However, some actions of nurse leaders can be attributed to servant leadership. When a nurse leader is concerned with the quality of care, workplace safety, the professionalism of the personnel, and the accessibility to health services, and proposes relevant initiatives, they act as a servant leader (Fahlberg & Toomey, 2016).

The paradigm of servant leadership views a leader as someone more concerned with helping others achieve their goals. In the context of nursing, nurse mentors that aspire to assist new nurses or students in achieving professional excellence, and managers that listen to the needs of their team members and alleviate cultural and other differences to promote teamwork, can be considered servant leaders (Fahlberg & Toomey, 2016). To fully align with the servant leadership paradigm, nursing should represent not only patient care but also productive relationships, a community where everyones opinion is valuable, and a platform for helping others grow.

It is imperative for nurses to understand that continuous professional development is critical in providing patients with quality care. Therefore, healthcare leadership should also concentrate on creating productive learning environments and encourage staff to participate in personal education. Previously, it has been considered that the authentic leadership style is the most appropriate for achieving nursing goals (Best, 2020).

Authentic leaders are self-aware, know how to understand others, and welcome leadership transparency (Best, 2020). However, this paradigm is not sufficient to cause a change in organizational cultures  although nurses represent half of the global medical workforce, only a few nurses hold decision-making positions (Best, 2020). Servant leadership, on the other hand, can unite all nurses through encouraging ubiquitous collaboration and professional development.

Secularism is the idea of using other people to achieve organizational or personal goals. This concept contrasts with the servant leadership paradigm because the latter is more concerned with helping others achieve their aims and encouraging their development (Best, 2020). Most of the leaders in the business world can be considered secular leaders because they hire personnel and form teams to make them accomplish the leaders objectives.

References

Best, C. (2020). Is there a place for servant leadership in nursing? Practice Nursing, 31(3), 128-132.

Fahlberg, B., & Toomey, R. (2016). Servant leadership: A model for emerging nurse leaders. Nursing2020, 46(10), 49-52.

Summary

The process of nursing tasks delegation is fairly similar across the United States, yet certain characteristics are unique to specific areas. In Virginia, the legal criteria for delegation in the nursing setting start with the assessment of the target population, to whom the specified nursing services are to be delivered (Virginia General Assembly, n.d.). Afterward, the needs and key steps are prioritized, followed by the identification of the quality standards that will have to be met in the process (Virginia General Assembly, n.d.). As soon as the specified goal is completed, the key objectives are communicated to nurses, educational and training standards are located, and appropriate resources are allocated (Virginia General Assembly, n.d.). The specified steps are expected to lead o the effective delegation of key nursing responsibilities according to the Virginia laws.

Improper Delegation

In compliance with the existing standards for nursing care delegation may lead to severe outcomes for both patients and nurses. In the case of the former, the failure to meet the pre-established requirements for care may affect patients health seriously, leading to the development of complications, chronic disorders, and even death (Young et al., 2016). Indeed, given the range of tasks that can be delegated in the course of managing patients needs, including the collection of information such as patients vital signs and changes in their well-being, inaccurate data may lead to medical errors (Young et al., 2016). As a result, patients may be provided with doses of medication that are too high or too low, given wrong instructions, and presented with otherwise inaccurate information about managing their health (Young et al., 2016). For nurses, in compliance with the delegation standards will inevitably entail penalties and, in case of patients health being impaired, entail resignation, loss of the license, or even a lawsuit (Young et al., 2016). Therefore, ensuring that the nursing services are delegated in a proper and correct manner is essential.

Barriers

Although numerous measures have been introduced to improve the quality and efficacy of care, multiple obstacles to the delegation of key tasks remain in their place. The barriers such as poor interdisciplinary collaboration, inefficient communication, and high workload rates reducing the efficacy of delegation are still significant hindrances for nurses in most healthcare facilities (Young, Farnham, & Reinhard, 2016). The specified barriers are intertwined closely with each other; for instance, the absence of effective communication tools causes significant difficulties in the enhancement of collaboration (Young et al., 2016). In turn, high turnover rates and low levels of staffing in most healthcare organizations have a direct impact on the extent of workload that nurses have to endure (Young et al., 2016). As a result, delegating tasks becomes impossible, with most nurses already being busy with a plethora of assignments and responsibilities (Young et al., 2016). Consequently, the threat of medical errors increases as the quality of communication leaves much to be desired, whereas the extent of workload and the unwillingness or inability to cooperate contribute to the aggravation of the nursing environment.

Risk Mitigation Strategies

To reduce the extent of legal risks to which nurses may be subjected once the delegation processes are implemented incorrectly, a nurse manager may need to design specific strategies adjusted to the needs of the target population. However, when applying the specified concern to a general environment, one may consider the options such as the update of the instructions for key procedures, the use of innovative technological tools for improving communication, and the reinforcement of corporate policies concerning collaboration. The integration of the latest technological solutions will allow making the communication process more useful, at the same time enabling improvements to the current schedule and the arrangement of the workload (Fisher, Croxson, Ashdown, & Hobbs, 2017). As for collaborative practices, they will reduce the number of cases involving information mismanagement, thus preventing medical errors. Most importantly, making instructions more concise and palatable will help nurses to deliver services in a more accurate and effective fashion (Fisher et al., 2018). Thus, the legal risks that the improper delegation of tasks and responsibilities may entail will be mitigated.

References

Fisher, R. F., Croxson, C. H., Ashdown, H. F., & Hobbs, F. R. (2017). GP views on strategies to cope with increasing workload: A qualitative interview study. British Journal of General Practice, 67(655), 148-156.

Virginia General Assembly. (n.d.). Administrative code.

Young, H. M., Farnham, J., & Reinhard, S. C. (2016). Nurse delegation in-home care: Research guiding policy change. Journal of Gerontological Nursing, 42(9), 7-15.

I agree with the current vision of the profession as it continues to maintain the reaching of established goals and recognizes the need for introducing new changes. Education continues to be a prevalent topic within discussions of the future of nursing, as accessibility and progression academically continue to be vital for the entire field. Diversity and leadership development has become increasingly important to nursing, as it is a profession that requires many skills that depend on competent leadership, cultural awareness, and other qualities (American Nurse, 2019). As such, the current vision that promotes these attributes is essential for the growth of the nursing profession.

Because current initiatives and goals engage nurses more directly, the goals are likely to be more realistic as they are based on the insight of working professionals. It is not possible to address all the issues within nursing in a complete manner, but adequate leadership within nursing practices has the ability to prioritize and discern immediate issues. As such, the goals that address diversity, equality, and education among nurses for the coming years are realistic and attainable at a consistent pace. However, it is also important to note that the achievement of many of the goals relies on community and government interference, which may both positively and negatively affect the achievement of said goals.

I hope to contribute to the nursing field through my leadership qualities and my ability to communicate while being socially and culturally informed. The development of current technology is likely to contribute to the changing landscape of nursing, and as such, it is vital for professionals in the field to improve their skills that rely on human factors. In my opinion, leadership, efficient communication, and sensitivity to the needs of patients are integral to the performance of nursing tasks in the coming future.

Reference

American Nurse. (2019). Future of nursing 2020-2030: Extending the vision. American Nurse. Web.

Introduction

This paper compares and contrasts the nursing education systems of Saudi Arabia and China. The countries represent very different cultural, political, and historical backgrounds, and it is crucial to analyze their educational systems and discover what barriers, if any, exist to high-quality nursing education. As the demand for nurses increases worldwide, these countries should aim for collaborative learning to obtain the most effective workforce.

Political History and Development of Nursing Education

Saudi Arabia

Nursing education in Saudi Arabia began in 1954 as a one-year program. Only in 1976 did a degree-granting training program for a Bachelor of Science in Nursing (BSN) appear. In the first few decades, nursing education was offered solely to female students; in 2004, a program for men was designed (Almalki, FitzGerald, & Clark, 2011).

China

The modern nursing education system was developed after the arrival of Western missionaries in the late 19th century, when a three-year training program was introduced. Throughout the 20th century nursing education developed under the influence of the Cultural Revolution. Progress was made when universities began to offer secondary education programs in nursing education, allowing more advanced nurses to obtain a higher degree of qualification (Wong & Zhao, 2012).

Comparison

The history of nursing education in Saudi Arabia is different from that of China, despite the fact that its intense development started in the second half of the 20th century in both countries. In China, education was accessible to everyone while only female students in Saudi Arabia could pursue the field in the beginning.

Government and Nursing Organizations Influencing Nursing Education

Saudi Arabia

The Ministry of Health (MOH) together with the Ministry of Higher Education suggested that the level of nurses entering into practice should be no lower than baccalaureate. Thus, they wanted to ensure a high quality of nursing education in the country (Jradi, Zaidan & Shehri, 2013). The Ministry of Higher Education recommended orienting on international educational standards when planning the curriculum.

China

The Ministry of Education regulates the procedure of entering into nursing practice. Since 2007, it has obliged graduates of all three levels to take a registration examination before starting licensed work. Founded in 1909, the Chinese Nursing Association (CNA) is the main organization for nurse support. It helps nurses protect their rights, strengthen academic exchange, and access general assistance while studying (Wong & Zhao, 2012).

Comparison

In both countries, governmental regulations play a vital role in nursing education by applying certain criteria for nurses to enter practice after training. In Saudi Arabia, the government requires an Associate degree or diploma in nursing to enter the profession, but in China, the type of degree defines the area of competence.

Current System of Nursing Education

Saudi Arabia

There are two educational levels managed by The Ministry of Health: health institutes and junior colleges. Both levels enable nurses to obtain a diploma or Associate degree in nursing with a technical nurse qualification. The Ministry of Higher Education also offers a few programs for a Bachelor of Science in Nursing (BSN) (Jradi et al., 2013). Nurses who obtain bachelors degree are regarded as professionals. In general, the training lasts five years, after which trainees may enter into practice.

China

Nursing education consists of three levels: diploma, advanced diploma, and baccalaureate degree. The first level lasts three years and is earned at hospital-attached health schools. The second is offered for senior high school or health school graduates who must take courses equivalent to a three-year course in nursing. The bachelors degree takes five years and is attainable for the second level graduates. Trainees must take an exam to start licensed work at advanced levels (Wong & Zhao, 2012).

Comparison

Both countries enable students to obtain university degrees in nursing at various levels depending on the educational facility. Nevertheless, the length of studies and the curriculum are different.

Post-Graduate (Masters) Education

Saudi Arabia

Post-graduate education in nursing offers a limited selection of masters programs for female students only. However, the government offers scholarships for students of both genders, and recipients can study at the masters and Ph.D. levels abroad.

China

Post-graduate education is available for everyone; however, admission is based on written examination scores and nursing skill. The masters degree program lasts three years and offers various subjects (e.g., political science, foreign language) together with nursing (Wong & Zhao, 2012). There are Ph.D. programs as well, but few students continue at this level.

Comparison

Post-graduate education in Saudi Arabia differs from that of China, both in terms of attitude towards gender and curriculum. Both countries allow students to study abroad and pursue advanced studies.

Conclusion

Students access to education varies around the world, as demonstrated by nursing education programs in Saudi Arabia and China. Though the systems may differ, the ultimate goal of both countries is the same: to produce highly skilled nurses and to provide high-quality health care services. There are issues in the educational systems of both countries in terms of bridging degrees. In order to meet their goals, these countries should consider applying foreign practices, including offering better student support on every level and making nursing education available to everyone.

References

Almalki, M., FitzGerald, G., & Clark, M. (2011). The nursing profession in Saudi Arabia: An overview. International Nursing Review, 58(3), 304-311.

Jradi, H., Zaidan, A., & Shehri A. M. (2013). Public health nursing education in Saudi Arabia. Journal of Infection and Public Health, 6(2):6368.

Wong, F.Y., & Zhao, Y. (2012). Nursing education in China: Past, present, and future. Journal of Nursing Management, 20(1), 38-44.

Professionalism and professional values of nursing are expressed via ethical and moral values of nurses. In most cases, the moral rules and values are presented by the hospital where nurses are working. The social norms are also important as in this case the norms of conduct are included as the main paradigm for behavior and actions of nurses.

The professionalism of nurses is expressed via their desire and possibility to follow the rules they are imposed. The patients with psychosocial diseases/disorders are referred to the patients with mental disorders, in other words to the category of patients who require specific treatment.

Dwelling upon the principles of ethics and professionalism in psychiatry, it is impossible to avoid the principles which have been developed by American Medical Association. A medical worker is to provide a highly professional care respecting a personal dignity and rights of a patient, referring to personal honesty, and respecting the law. The rights of the patients are to be respected by the professional nurses and the confidence and privacy of the patients are to be followed.

Physician-patient relationships should be based on respect, honesty, confidentiality, beneficence, trust and autonomy. Dealing with patients with psychosocial diseases/disorders, nurses are to understand that such people require more attention due to their peculiar position and the attitude should be different (Principles of ethics and professionalism in psychiatry, 2001).

The moral responsibility before the mentally ill patients is higher as while treating these people the nurses are to apply to all possible spheres in medical care. The mentally ill patients may react differently. Much attention should be paid to cross-cultural linkages as in some cases the social-cultural peculiarities of a particular person may create difficulties. Professional nurses are to cope with the problem, get to know more about the point for conflict and make sure that a patient is comforted (Tait, 2008) as according to the Principles of ethics and professionalism in psychiatry (2001) psychiatrists are to function in accordance with local law (n.p.).

One of the main moral and ethical values of any nurse should be the desire and intention to help patients to recover. Recovering in mental disorders field is a complicated issue which depends not only on medical workers, but also from a patients and a family, their desire and force. A professionalism of the nurses is measured by their possibility to encourage mentally ill people for recovering. It is usually rather difficult as living in their worlds mentally ill patients do not pay much attention to those who surround them. The possibility of a nurse making sure that a patient has recovered is one of the main activities of the nurses professionalism.

In conclusion, it should be stated that having the common moral and ethical rules which are dictated by the society, the professional nurses are also to follow the personal desires of the clients and the hospital rules. Patience and the desire to be useful should be the main virtues of the professional nurses as the work with mentally ill people requires much attention and delicacy.

Professional nurses are to treat the mentally ill patients in accordance with their needs, thus, the nurses are to adapt to the environment of a patient. Moreover, professional nurses will always think about the positive result even when the hopes are little as the professionals always develop their knowledge and skills which may positively impact the future outcome.

Reference List

Principles of ethics and professionalism in psychiatry. (2001). Web.

Tait, C. L. (2008). Ethical Programming: Towards a Community-centered Approach to Mental Health and Addiction Programming in Aboriginal Communities. A Journal of Aboriginal and Indigenous Community Health, 6(1), 29-60.

Research Critique

The possibility to use the information of the most current research while addressing critical clinical issues is an integral instrument of nurses, clinicians, and managers in their daily workflow. This allows healthcare providers to be updated on contemporary tendencies, therapeutic approaches, standards, and policies, which facilitates making quality medical and managerial decisions and delivering sound patient care. Thus, this paper aims at exploring and summarizing two qualitative articles that address the research question of what is more beneficial: increasing nursing workers or adding more working hours to improve nurses outcomes for patients. In particular, the first article by Cho et al. (2016) is titled Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: A cross-sectional study. The second article by Son et al. (2019) is titled Association of working hours and patient safety competencies with adverse nurse outcomes: A cross-sectional study.

Background of Studies

The Article by Cho et al. (2016)

The purpose of the given study is to examine the correlation between nurse staffing and overtime with nurse-perceived quality of care, care left undone, and nurse-perceived patient safety. The issue that the article tends to address is to determine whether and how nurse staffing and overtime affect the delivery of quality care. The study is significant for the nursing practice since it considers essential hospital characteristics, namely, quality of care, patient safety, and care left undone, and explores the effect of staffing and overtime on them.

The article by Son et al. (2019)

The objective of the article is to reveal the connection between patient safety competencies and the working hours of nurses with adverse nurse outcomes. The question that the authors try to answer is how the number of working hours of nurses influences patent safety. The given study has a profound significance for healthcare providers since it highlights the importance of regulating and controlling the schedule of nurses.

How Do These Two Articles Support the Nurse Practice Issue You Chose?

The two articles are directly related to the PICOT question of what is better for patients outcomes: an increase in the number of nurses or the addition of working hours. The article by Cho et al. (2016) explains that a shortage of working nurses and nursing overtime harm patient safety, the quality of care, and the amount of work done. Likewise, the study performed by Son et al. (2019) confirms that increasing working hours for nurses will bring harmful consequences to patient safety.

The focused groups of the two articles are also associated with those identified in the PICOT question. In particular, the sample size of the study by Cho et al. (2016) comprises nurses of all levels, who worked at inpatient units, including intensive care units, emergency rooms, and medical-surgical units. Regarding the article by Son et al. (2019), the sample size includes the nurses with different education, who are involved in the various clinical departments, such as surgical, intensive care, psychiatry, and emergency in particular. Therefore, in addition to other units, the two studies have nurses that are employed in the emergency department, which is relevant to the conditions of the PICOT question.

Methods of Studies

In the study conducted by Cho et al. (2016), a cross-sectional descriptive design was applied to do a survey that contains answers of nurses of all levels. The inclusion criteria involve nurses who had at least one year of working experience at tertiary care hospitals and had three eight-hour shifts a day. As a result, 364 nurses were enrolled with ages from 24 to 51 years; all participants were women. The second study has a cross-sectional design that used questionnaires of Aikens International Hospital Outcomes Study (IHOS). In contrast to the first article, this study includes diverse nurse characteristics, such as gender, age, highest education, years worked as a nurse, job status, and working unit. The sample size of this study involves 3037 nurses, which is notably larger than in the study by Cho et al. (2016).

Concerning the articles by Cho et al. (2016), the authors of the study manage to conduct a comprehensive survey that involves nurses working in different units of three hospitals. Concerning limitations, it should be indicated that one of the significant drawbacks can be the presence of only one gender, that is, women. Regarding the article by Son et al. (2019), the researchers used a vast sample size that includes over 3000 participants of different gender, education, and job status. One of the limitations is the absence of an age indicator.

Results of Study

The findings of the article by Cho et al. (2016) show that an increase in the number of patients per nurse leads to poor quality of care, failing patient safety, and having care left undone. In addition, regarding these characteristics, the outcomes of nurses who work overtime have appeared worse than the results of nurses who do not work overtime. As to the article by Son et al. (2019), the authors have concluded that nurses working fewer than 40 hours per week have better patient safety competencies than those who work extra hours. Moreover, nurses working over 50 hours a week demonstrated the worst outcome for patients.

Cho et al. (2016) recommend that in hospitals, the managers should provide adequate nurse staffing and working hours to enhance the quality and safety of care and reduce the amount of care left undone. The findings of the article by Son et al. (2019) indicate that there is a necessity to review the policy regarding working overtime in hospitals to prevent the adverse outcomes of nurses. Furthermore, according to the authors, managers of healthcare organizations should implement a system that protects the nurses rights regarding workload and schedule.

Ethical Considerations

Ethical Considerations are determined as critical requirements while conducting scientific research since non-compliance with these principles may lead to the failure of the experiment or survey. In the given two studies, it is worth discussing the further two ethical considerations, namely informed consent and the privacy of information. The first ethical principle implies that an individual consciously, deliberately, and voluntarily, clearly and honestly, gives his agreement for participation in the research. The second principle is closely related to respect for the fidelity and dignity of a participant; that is, the anonymity of respondents must be esteemed and protected.

Regarding the study performed by Cho et al. (2016), it should be indicated that the researchers follow the requirements of voluntary participation since all participants provided written consent. Besides, nurses privately completed the questionnaire by giving answers in sealed envelopes. Concerning the study by Son et al. (2019), the authors also managed to ensure voluntary consent by providing information sheets describing measures to preserve confidentiality, the voluntary nature of participation, and the right of withdrawal. Finally, the participants returned answers in the form of a sealed envelope or box.

In summary, the paper has examined two qualitative articles relevant to the PICOT question of what is more beneficial: increasing nursing workers or adding more working hours to improve nurses outcomes for patients. In particular, the study by Cho et al. (2016) proved that the shortage of nurses leads to an excessive workload, which negatively impacts their performance. Moreover, the two articles firmly do not recommend adding extra hours to the regular schedule since this measure results in inadequate safety and quality of care for patients. Thus, in the context of the PICOT question, increasing clinical staff will be relevant to enhance medical outcomes for patients.

References

Cho, E., Lee, N.-J., Kim, E.-Y., Kim, S., Lee, K., Park, K.-O., & Sung, Y. H. (2016). Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: A cross-sectional study. International Journal of Nursing Studies, 60, 263271. Web.

Son, Y. J., Lee, E. K., & Ko, Y. (2019). Association of working hours and patient safety competencies with adverse nurse outcomes: A cross-sectional study. International Journal of Environmental Research and Public Health, 16(21), 4083. Web.

The profession of a nurse requires specialists to possess certain knowledge to direct their practice. Nursing knowledge has developed through several eras since the 1900s and is now characterized by the theory utilization era (Alligood, 2014). In the current period, nurses are meant to use philosophies, models, and theories for theory-based practice, with nursing frameworks being the knowledge for quality care (Alligood, 2014). The theory is important for the professional discipline, as nursing theoretical works guide reasoning and decision-making and propose specific outcomes (Alligood, 2014). For instance, the Theory of the Person as an Adaptive System is quite focused and can navigate a nurses approach and mindset (Alligood, 2014). Nursing theories provide fundamental nursing information, joining knowledge and action (Alligood, 2014). Nursing professionals need theory-based knowledge that is critical in achieving outcomes in nursing practice.

Furthermore, Virginia Henderson suggests an issue related to applying theory in practice. Her Nursing Need Theory focused on the significance of increasing patient independence, and Henderson highlighted basic human needs as the priority of nursing practice. However, such emphasis indicated a lack of theory regarding patient needs and how nurses can meet those needs. Henderson proposed good health is a challenge affected by various factors, including age and cultural background. One should remember that Henderson was an early theorist, and in the beginning, a recognition emerged that theory from different disciplines was specific to those disciplines and not nursing (Alligood, 2014). As Henderson prioritized patient needs, her perspective has led to further theory development.

Reference

Alligood, M. R. (2014). Nursing theory: Utilization & application (5^th ed.). Mosby.