Category: Nursing

Introduction

There are many attitudes towards healing and approaches to be applied in nursing practice. Martha Rogers is one of the theorists known for her futuristic views about nursing and the intention to conceptualize the interaction between a person and the environment (Smith, 2018).

Her theory of Emergence of Paranormal Phenomena focuses on paranormal manifestations in this type of relationship and explains the effects of distant healing and various energy therapies. In other words, pandimensional practices can be theoretically approved and identified in nursing. In this paper, pandimensional awareness will be discussed to investigate the worth of healing practices, and overall attitude towards the paranormal phenomenon, and the effectiveness of pandimensional healing in healthcare settings.

Pandimensional Practice Essence

In my opinion, pandimensional can be defined as something that is beyond a personal understanding of reality. This term covers the events that are hard to explain by means of the already known and proved theories and rules. Therefore, instead of searching some clear explanations and evidence, it is easier for people to say that some paranormal phenomena take place. In many cases, healthcare and medical experts believe that safeguarding is crucial for health promotion, and if patients respect the idea of paranormal in healing, specific strategies and practices need to be chosen (Donizzetti & Petrillo, 2017).

Personally, I want to believe in the theory developed by Rogers about the Emergence of Paranormal Phenomena. In some situations, it is hard to find a rational solution to a health problem, and the only thing that is left is to believe that some extraordinary powers. Although I have not yet experienced this practice in my life, believing is something that cannot be taken from me.

Examples and Personal Attitudes

The examples of healing practices that may fall within Rogers theoretical perspectives vary. Some patients find it effective to trust their health in the hands of people who offer energy therapies like therapeutic touch, praying, or meditation (Smith, 2018). In some cultures, spiritual connection plays an important role, and the results of healing depend on how well they ask for forgiveness or help. Despite the right to have personal opinions and attitudes, nurses must respect any healing practice and apply paranormal phenomena to nursing care. Special rooms for meditation, small churches within hospitals, and communication with patients about their religious beliefs and norms are possible nursing interventions.

Effectiveness

It is hard to evaluate the effectiveness of paranormal phenomena in healing practice because people cannot offer clear and evidence-based explanations to what actually happens in such a care process. Therefore, the evaluation may be based on such factors as patient satisfaction, the presence/absence of positive outcomes of care, the development of trustful relationships between a nurse, a patient, and his/her family. An overall condition of a patient after a paranormal healing practice occurs is the best explanation if it is necessary or dangerous to support pandimensional healing.

Conclusion

In general, there is no one common attitude towards paranormal phenomena and pandimensional activities in nursing practice. Sometimes, spiritual well-being, respect to traditions, and cultural ceremonies are necessary to motivate patients and their families. Martha Rogers offered a clear and well-defined theory to support the possibility of these practices. Although paranormal healing can hardly be accepted by nurses around the whole world, a chance for this practices effectiveness still exists and cannot be neglected.

References

Donizzetti, A. R., & Petrillo, G. (2017). Validation of the paranormal health beliefs scale for adults. Health Psychology Open, 4(2), 1-8. Web.

Smith, L. (2018). Health and illnesses frameworks. In R. Utley, K. Henry, & L. Smith (Eds.), Frameworks for advanced nursing practice and research: Philosophies, theories, models, and taxonomies (pp. 127-140). New York, NY: Springer.

Introduction

The work of junior medical personnel requires professionalism and a responsible approach to the performance of immediate duties. At the same time, in order to differentiate the qualifications of nurses, there are specially licensed degrees that determine the range of rights and powers of employees. The activities of specialists who do not have the appropriate confirmation of the level of professional training are allowed, and certain standards are determined by official documents and regulations. Based on the provisions of the Florida State Board of Nursing, the apportionment of duties will be reviewed, and employees responsibilities regarding delegation principles will be evaluated. This work is aimed at analyzing the role of unlicensed assistive personnel and registered nurses, as well as the conditions for the delegation of patient care tasks.

Roles of Unlicensed Assistive Personnel and Registered Nurses

The activities of those employees who do not have the official confirmation of nursing qualifications are permissible in accordance with the state legislation. The Florida Administrative Code and Florida Administrative Register (2010) define the rights and obligations of unlicensed assistive personnel in section 649B-14 of the State Board of Nursing. According to the document, these employees may provide patient care services on an assistive or delegated basis without a special confirmation of their working degree (Florida Administrative Code, 2010). The competencies of these workers are not enough to make decisions regarding the specifications of care, but they are allowed to perform nursing functions that do not require narrow-profile qualifications.

Registered nurses have sufficient authority to participate in the provision of care services and plan a mode of interaction with patients. Also, specialists of this qualification have the right to delegate the authority of unlicensed assistive personnel. However, based on specialized legislation, registered nurses are not allowed to delegate authority in accordance with certain conditions (Florida Administrative Code, 2010). In particular, the performance of care responsibilities cannot be trusted to unlicensed personnel if these tasks require special knowledge or skills that entail specific patient outcomes.

Special requirements are applied to registered nurses regarding the delegation of patient care tasks. According to the Florida Administrative Code and Florida Administrative Register (2010), evaluating care progress and planning interventions are unacceptable tasks that unlicensed staff is not allowed to perform. Also, any issues related to the diagnosis and interpretations of subtotals are forbidden for delegation in the conditions of the cooperation of registered and unregistered nurses. The competencies of unlicensed personnel are limited, and this fact is key in planning joint activities and interventions for specific cases. Therefore, the delegation of tasks carried out by registered nurses has a number of limitations and conventions that are to be taken into account in order not to violate the state official legislation.

Responsibilities of Unlicensed Assistive Personnel in the ICU Environment

In conditions of the mutual cooperation of registered nurses and unlicensed assistive personnel, special forms of interaction may occur, and their impact on patient outcomes may be significant. Productive collaboration in intensive care units is a crucial aspect of nurses work since the features of care in such departments differ from those in a standard clinical environment. The cooperation of registered and unlicensed specialists creates special conditions for interaction, which are characterized by the delegation of authority and special principles employees work.

Assessing the differences in the diverse conditions of activity allows describing the challenges that are to be overcome. For instance, according to the study conducted by Bellury, Hodges, Camp, and Aduddell (2016), when working in the intensive care unit, unlicensed assistive personnel may be less attentive, which results in insufficient reporting. At the same time, based on the official working requirements, registered nurses are responsible for all the mistakes in case of the delegation of authority. Therefore, the most difficult tasks, as a rule, are carried out by licensed specialists in order to minimize errors and prevent poor patient outcomes.

In the considered clinical environment, role distribution is of great importance. As Bellury et al. (2016) state, in intensive care units, more attention is paid to team-building strategies to improve the quality of communication among the employees of different profiles and establish productive interaction. The authors note that in acute care settings, unlicensed assistive personnel can perform routine duties, which, nevertheless, is significant for patients and, at the same time, reduces the burden on registered nurses (Bellury et al., 2016). The organization of conditions for high productivity is one of the essential tasks in such departments, and, despite varying degrees of responsibility, employee loyalty plays an important role in the final results of nursing interventions. Therefore, the cooperation of licensed and unlicensed employees in intensive care units is characterized by special conditions and rules.

Conclusion

The delegation of patient care tasks carried out by registered nurses to unlicensed assistive personnel implies a number of conditions and features that are essential to consider. The roles of employees are different, and the main responsibility lies with workers with proven qualifications. In intensive care units, productive collaboration between the two groups of medical personnel is a crucial aspect, and strategies to improve the quality of communication and accountability for any decisions are promoted.

References

Association of Womens Health, Obstetric and Neonatal Nurses. (2016). The role of unlicensed assistive personnel (nursing assistive personnel) in the care of women and newborns. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(1), 137-139. Web.

Bellury, L., Hodges, H., Camp, A., & Aduddell, K. (2016). Teamwork in acute care: Perceptions of essential but unheard assistive personnel and the counterpoint of perceptions of Registered Nurses. Research in Nursing & Health, 39(5), 337-346. Web.

Florida Administrative Code & Florida Administrative Register. (2010). Delegation to unlicensed assistive personnel. Web.

The model of nursing care

The observed model of nursing practice is primary nursing that was used in the practice setting. The identification of this particular model was possible due to the observed patterns of practice the nurses utilized. Every patient was assigned a nurse practitioner who was entirely responsible for the treatment process. According to the primary nursing model, a nurse in charge of a particular patient makes all the decisions and carries out a treatment plan for his or her patient. One nurse provides care for several patients within a shift and sustains throughout a term of hospitalization. Thus, the observed process of decision-making carried out by one responsible nurse and the scope of interventions provided for the patients indicated that the model used in the organization is primary nursing.

The scholarly resource related to the nursing care model

The primary nursing model is broadly addressed in the academic literature. According to Mattila et al. (2014), the advancement in the field of nursing care requires more opportunities for nurses autonomy to be able to provide high-quality service for well-informed patients with high expectations. The primary nursing model gives an opportunity to establish relationships with patients and their families, as well as ensure professionals competence and consistency of care. In general, primary nursing is a type of infrastructural organization of a health care organizations work within which patient care is the responsibility of a named nurse for the duration of the patients hospital stay (Mattila et al., 2014, p. 2). This model is based on a patient-oriented approach and ensures trusting relationships between nurses and patients, as well as guarantees the sustainability of healthcare service.

The scholarly resource related to a different nursing care model

The team nursing model is different from primary nursing because it deploys a contrasting approach to the organization of work within an organization. The article by Hastings, Suter, Bloom, & Sharma (2016) claims that this model provides an opportunity to ensure highly qualified care within collaborative work without compromising quality (p. 1). The study evaluates patient outcomes, service cost changes, and efficacy of human resource management within the team nursing model. The hierarchical distribution of responsibilities and decision-making enables the staff to provide high-quality service based on the collaborative work on the solution-finding. The research findings indicate that this approach has visible positive effects on human resource outcomes; the lack of negative implications for patient care suggests the possibility of a broad application of the team nursing model.

Different nursing care models and their implementation

The team nursing model is based on the hierarchical organization of care. In this case, a group of nurses works with one patient, sharing responsibilities and carrying out decision-making together. On the contrary to primary nursing, this approach ensures including different professional views and finding the best option for the most effective patient outcome (Campbell & Richard-Eaglin, 2018). The quality of nursing care is validated by evidence-based practice. This implication affects the safety issue because the patients treatment is more secure when a group of qualified specialists verifies the best care plan. The implementation of team nursing might improve staff satisfaction due to the opportunities to grow professionally in a group and delegate responsibilities within a hierarchy.

Lessons learned about the two nursing care models

In conclusion, this assignment allowed me to observe the practical implementation of the primary nursing model and compare it to the team model. Within primary nursing, a nurse is completely responsible for the whole stay of a patient in a hospital. It enables quality and consistency of care but imposes difficulty of work and limits evidence-based care. Team nursing, on the contrary, engages a group of qualified nurses who perform within a hierarchy. It provides more opportunities for high-quality, evidence-based care, better patient safety outcomes, and cost-effectiveness of service.

References:

Campbell, J. G., & Richard-Eaglin, A. (2018). Implementing an integrated team-based model of care. North Caroline Medical Journal, 79(4), 228-229. Web.

Hastings, S. E., Suter, E., Bloom, J., & Sharma, K. (2016). Introduction of a team-based care model in a general medical unit. BMC Health Services Research, 16(245), 1-12. Web.

Mattila, E., Pitkänen, A., Alanen, S., Leino, K., Luojus, K., Rantanen, A., & Aalto, P. (2014). The effects of the primary nursing care model: A systematic review. Journal of Nursing and Care, 3(6), 1-12. 

The theory of Maslows hierarchy of needs presents a five-tier model that can be applied to the nursing profession. The lowest tier is physiological needs: food, sleep, and shelter. In regards to nursing, it can be interpreted as the importance of maintaining physical well-being in the workplace. It is no secret that, at times, the workload at medical facilities is so daunting that nurses neglect healthy nutrition or suffer from sleep deprivation. To successfully meet the needs of the lowest tier, employees should be offered better schedules that include meal breaks.

The next tier concerns safety, and for nurses, it may mean protection from bullying and aggression on the job. Therefore, a nursing leader should ensure security on the job. The third tier deals with the feeling of belonging to a valued group. It goes without saying that the medical field requires close teamwork. However, what is often dismissed is that building cohesion also benefits nurses at the individual level. Getting to know each other through a series of appropriate activities might be the way to go.

The fourth tier entails esteem needs  validation, acknowledgment, and a sense of accomplishment. These phenomena are directly tied to job satisfaction and should be promoted through personal interactions (Liu, Aungsuroch, & Yunibhand, 2016). Timely feedback and appraisal might be just what a nurse needs to feel valued in the workplace. Lastly, the highest tier of the hierarchy is self-actualization, which means the realization of a persons full potential. Arguably, self-actualization is an individual task whose completion should not be shaped by external forces. At this level, a nurse should decide for him- or herself whether this profession or this particular position fits their vision.

References

Liu, Y., Aungsuroch, Y., & Yunibhand, J. (2016). Job satisfaction in nursing: A concept analysis study. International Nursing Review, 63(1), 84-91.

Introduction

Nursing theorists and their work have a significant impact on nurse education and clinical practice. They can be applied both in theoretical research and used practically in diverse interventions aimed at the improvement of patient care quality and patient outcomes. One of the theories most commonly employed in practice is Dorothea Orems Self-Care Deficit Theory of Nursing. Orem received her nursing diploma in the 1930s and started her career at Providence Hospital School of Nursing in Washington (Berbiglia & Banfield, 2014). In the following decades, she received her BS and MS degrees in Nursing Education. She worked throughout the country following her goal to improve nursing in general hospitals. She is also known for developing a definition of nursing practice and a significant contribution to the nurse education curriculum (Berbiglia & Banfield, 2014). Orem was conferred with many rewards such as the honorary degree of Doctor of Science (1976), the CUA Alumni Association Award for Nursing Theory (1980), etc. This paper aims to analyze the major concepts of the self-care deficit theory, its application in clinical practice, and theory relevance to contemporary healthcare as a whole and patients in particular.

Analysis of Basic Concepts and Major Relationships in the Theory

The self-care deficit theory of nursing consists of four related theories. The first one, the theory of self-care, includes a description of reasons and ways people use to care for themselves. The second theory of dependent-care includes the ways family members and/or friends provide dependent-care for a person who is socially dependent (Berbiglia & Banfield, 2014, p. 244). Next, the theory of self-care deficit describes and explains methods of help for people who need it that can be provided through nursing. Finally, the theory of nursing systems implies descriptions and explanations of relationships that must be developed and preserved for effective nursing involvement in self-care provision (Berbiglia & Banfield, 2014). The major concepts of these theories are interrelated.

The basic concepts of nursing theories are person, environment, health, and nursing. In Orems theory, a person is a patient capable of self-care or having needs that can be satisfied by the family of nursing care. Environment, in turn, creates the context in which the person exists. The environment has an impact on the person and can be modified by nurses to satisfy the needs of a patient. Health is treated as a condition of soundness or wholeness as well as the bodily and mental functioning. Nursing in the context of self-care theory comprises actions performed by nurses to provide therapeutic self-care, lead the patient to responsible self-care, or deliver supervision and consultation related to care. All these concepts are interrelated and interdependent. Thus, the person is central to Orems theory. A persons health is influenced by the environment as well as nursing actions. A healthy person does not need assistance in self-care provision. Nevertheless, when the health condition is under the impact of illness, some patients cannot complete self-care activities and need help from other individuals or nurses.

The self-care deficit theory of nursing is widely applied in different aspects of clinical practice. For example, Mohammadpour, Rahmati Sharghi, Khosravan, Alami, and Akhond (2015) examine the impact that a supportive educational intervention grounded on the theory concepts has on the way patients with myocardial infarction provide self-care. The problem that led to the necessity of such interventions is the lack of knowledge of patients with the cardiovascular disease about their health peculiarities and, consequently, are not able to perform self-care. The major finding of this study is an increase in levels of self-care knowledge in patients of the experimental group compared to those of the control group. Also, self-care motivation and skill levels were higher as well. Thus, the self-care deficit theory of nursing can be applied as a basis for educational interventions in patients with health problems.

Another application of the self-care deficit theory is presented in the study by OShaughnessy (2014). The researcher investigated the effect of Orems theory on the elderly patients on peritoneal dialysis. The study describes the use of Orems self-care deficit theory as a model for leading healthcare providers in addressing the capabilities of self-care of the older generation. The researcher claims that the application and promotion of peritoneal dialysis is one of the possible therapies which positively influence the quality of life with an increased sense of self-worth in elderly patients. The major finding in this study is that due to the use of self-care theory, the elderly patients demonstrate improvement in technique while peritonitis-free survival rates are similar to those of the younger population (OShaughnessy, 2014). Therefore, the theory under analysis has the potential to improve patient outcomes.

The self-care deficit theory can be applied in the field of womens health. Wong, Ip, Choi, and Lam (2015) suggest using Orems theory to examine self-care behaviors and their associated factors among adolescent girls with dysmenorrhea. Path analysis resulted in the following findings. First of all, age and received menstrual education influenced selfcare behaviors through selfcare agency both directly and indirectly. Secondly, the educational level of parents, pain intensity, as well as self-medication applied by adolescent girls when experiencing dysmenorrhea had an only direct impact on self-care behaviors (Wong et al., 2015). Thus, it can be concluded that self-care agency and self-care behaviors, which are the components of Orems theory, are applicable to clinical practice research.

Theory Relevance

The self-care deficit theory was developed by Dorothea Orem, an American nursing theorist (Berbiglia & Banfield, 2014). Although created in the twentieth century, the theory is still relevant and broadly used in contemporary health care. Self-care deficit theory focuses on a client or patient, which is typical of a popular model of patient-centered care. Moreover, Orems theory is frequently used as a basis for research and healthcare interventions. For example, its effectiveness is proven for education in myocardial infarction patients (Mohammadpour et al., 2013), self-care of elderly patients on peritoneal dialysis (OShaughnessy, 2014), and educating adolescent girls with dysmenorrhea (Wong et al., 2015). Therefore, the theory is still relevant and applicable to different aspects of clinical practice.

Summary

To summarizing, it should be mentioned that the self-care deficit theory has both strengths and limitations. The strengths are as follows. First of all, the theory is a comprehensive base for nursing practice due to its applicability in diverse spheres of nursing. Thus, it is effective in clinical practice, educational interventions, administrative work, and research. Secondly, the theory can be used by both experienced practitioners and graduate nurses. Finally, the strength of the theory is that it advocates for the application of nursing processes. The following limitations do not depreciate the theory but should also be considered. First of all, the theory looks illness-oriented. Secondly, Orem treats health as being in one of the three conditions, which implies that nursing systems are fixed and constant while health is traditionally considered to be dynamic. Moreover, there is little attention to the emotional needs of a person due to the focus on physical care. Nevertheless, despite some limitations, the self-care deficit theory is a valuable contribution to both practical and theoretical aspects of nursing and is used in a variety of spheres.

References

Berbiglia, V. A., & Banfield, B. (2014). Self-care deficit theory of nursing. In M. R. Alligood (Ed.), Nursing theorists and their work (8th ed.) (pp. 240-285). St. Louis, MR: Elsevier.

Mohammadpour, A., Rahmati Sharghi, N., Khosravan, S., Alami, A., & Akhond, M. (2015). The effect of a supportive educational intervention developed based on the Orems self-care theory on the self-care ability of patients with myocardial infarction: A randomised controlled trial. Journal of Clinical Nursing, 24(11-12), 1686-1692.

OShaughnessy, M. (2014). Application of Dorothea Orems theory of self-care to the elderly patient on peritoneal dialysis. Nephrology Nursing Journal, 41(5), 495-498.

Wong, C., Ip, W., Choi, K., & Lam, L. (2015). Examining self-care behaviors and their associated factors among adolescent girls with dysmenorrhea: An application of Orems self-care deficit nursing theory. Journal of Nursing Scholarship, 47(3), 219-227.

Introduction

A theory refers to a provisional statement that addresses key issues in human life and plays a vital role in shaping their behaviour. Nursing theories are claims that explain the principles of this practice and originate from deductive or inductive interpretations. They enable nurses to predict and describe facts and guide them through the process of knowledge generation on future nursing projects (Meleis 2011). These theories enable nurses to identify what they know and what needs to be known to enhance their performance.

Objectives

There are four objectives that guide this profession namely person, environment, health and nursing. These objectives form concepts that guide nurses during service delivery and interactions with patients and their environment.

When people fall sick, they seek immediate medical attention from their preferred health facilities. Nurses must attend to patients needs that originate from their cultures, religions, psychologies, physiologies or social units of life (Watson 2008). They must identify the relationship between their patients and other members of society. Moreover, it is essential to identify their patients positions to provide reliable medical care without interfering with their lives. Therefore, these theories enable nurses to examine their role in providing patients needs and assess their future demands (Masters 2011). They prioritise their services according to urgency and importance while providing quality services to their patients. For instance, an expectant woman qualifies to be a patient since she needs medical care. She must seek essential health services to ensure she delivers a healthy and normal baby and remain healthy before, during and after delivery.

Nursing theories ensure patients access healthcare services without interfering with their social, political or economic beliefs. This forms a crucial element that promotes a healthy environment for nurses and patients (Meleis 2011). These theories ensure nurses observe factors (external and internal) that affect the provision of quality services. At the same time, these theories ensure nurses work in a favourable environment free from destructors. A positive environment will ensure a patient is healthy and gives nurses an opportunity to utilise their potentials fully (George 2010). A nurse in the labour and delivery section must ensure an expectant woman avoids strenuous activities, confrontations and drugs without medical prescriptions.

Health refers to the well-being of an individual in terms of mental, social and physical stability. Nursing plays a key role in ensuring people are healthy by educating them on ways of improving their hygiene and taking care of their environment. In addition, nurses provide vital information on the likelihood of infections caused by genes, lifestyle and environment and how to reduce infection risks (Watson 2008). People have two health stages that involve normalcy and sickness. Nurses working in the labour and maternity section must ensure their clients attend regular medical check-ups during and after pregnancy. This will enable nurses to monitor the development of the foetus and mothers health.

Nursing is an essential concept that guides the provision of health services. This is a unique profession that not only involves patients but also their communities. Even though, most people think that nursing takes place within the confines of healthcare facilities the practice goes beyond these facilities. In fact, nursing is an extremely wide profession that involves the treatment, care and education on health issues. Nursing integrates patients needs with those of their communities to ensure steady healing, prevention of diseases and reduce pain in terminally ill patients (Masters 2011). Therefore, this profession involves more than what society believes it does. An expectant woman and her family members must know the demands and expectations of pregnancy. Therefore, nurses must ensure they guide expectant women in accordance with pregnancy practises outlined in the nursing portfolio. This will ensure they get quality services and go through pregnancy without complications.

Conclusion

Nursing theories guide nurses and patients towards achieving a healthy environment without straining the existing resources. There is a need for coordination amongst nurses, patients, family members and governments to ensure people access quality medical services.

References

George, J. (2010). Nursing Theories: The Base for Professional Nursing Practice (6^th Edition). New Jersey: Prentice hall.

Masters, K. (2011). Nursing Theories: A Framework for Professional Practice (Masters, Nursing Theories). Massachusetts: Jones and Bartlett Learning.

Meleis, A. (2011). Theoretical Nursing: Development and Progress. New York: Lippincott Williams and Wilkins.

Watson, J. (2008). Nursing: The Philosophy and Science of Caring, Revised Edition. Colorado: University Press of Colorado.

Introduction

Nursing is an essential part of the healthcare system that has significant human resources and the capacity to meet the needs of the population for affordable and acceptable health care. Nursing specialists play a crucial role in ensuring the availability and quality of medical services provided to society, strengthening preventive orientation, and solving problems of medical and social care. This paper will discuss the evolution of nursing practice, education, and communication that influence patients outcomes and approaches to treating people.

Evolution of Nursing Practice

Until recently, patient care had been most instructive and empirical (when more reliance was placed on experience or observation than on scientific research). Gradually, the scope of practice has changed as nursing leadership, health promotion, ethical, and inclusion practices emerged and were implemented in hospitals. Nursing practice was transformed into an independent professional activity based on theoretical knowledge, evidence-based practice, scientific judgments, and clinical thinking.

Through trial and error, the nurse found the means that should help the patient, and many sisters became professional thanks to the accumulated experience of caring for patients. Nurses got an opportunity to get specialization and to familiarize themselves with high-tech technologies as patient records currently are digitalized (Papandrea, 2016). Due to these changes, the approach to treating the individual had changed accordingly: patients started getting individual, tailored treatment with fewer interruptions occurred while getting help (Bravo et al., 2016). In their work, nurses use knowledge in various disciplines, such as anatomy, physiology, pathology at the same time. Modern nursing had developed its scientific knowledge and methods of applying them in practice.

Associate and Baccalaureate Education in Nursing

The scope of practice between an associate and baccalaureate nurse has changed over time as the nursing responsibilities evolved. There appeared a differentiation between several stages of education that helped to get structured knowledge and skills required to get a license. The division of education also helped to determine who people should contact in different situations when it comes to a broader or narrower scope of practice.

An associate and baccalaureate education in nursing gives nurses similar practice courses nowadays, such as ethics, legislation, and standards of practice, nursing knowledge and skills, continuous learning and improvement, and evidence-based practice. At the same time, baccalaureate education gives nurses additional competencies, such as e-health and ICT in nursing, and healthcare research and development practice that an associate education lack, according to American Nurses Association (2015). Thus, baccalaureate education gives more sophisticated competencies and knowledge that helps nurses to participate in the quality improvement activities in nursing.

BSN- and ADN-prepared Nurses Differences

Associate Degree in Nursing (ADN) program or a Bachelor of Science in Nursing (BSN) program prepares nurses to work in different care situations. Even though both degrees educate nurses to provide professional care, there is a difference between the BSNprepared nurse and the ADN nurse that is based on the quality of education nurses get (ADN and BSN Nursing Pathways). The BSN-educated nurses can make decisions based on research and analysis of historical and current data that helps a nurse to elaborate better solutions to patients situations.

The ADN-prepared nurses can be named a technical professional because a nurse is focused on the clinical experience with assessments and needles and tube manipulations. Thus, the nursing care difference between the BSN- and ADN-prepared nurse is based on the competencies they got to analyze data and implement best practices.

Significance of Evidencebased Practice in Nursing

Evidence-based practice (EBP) to nursing care is highly significant when it comes to finding proper solutions to patients situations. By applying evidence-based practice, nurses ensure that the way of treatment that was chosen is based on objective data and its analysis. EBP includes several steps of identification and assessment of the evidence that helps nurses to justify their decisions and changes related to effective management and care practice.

The academic preparation of the RNBSN nurse supports EBP application by giving students care strategies that are proved to be active and encouraging them to choose methods and interventions that are validated by scientific communities (Why Is Evidence-Based Practice, 2018). The education of nurses that involves evidence-based practice ensures that a patient will get researched and tested treatment practices that adhere to ethical and scientific principles.

Nurses Communication in Interdisciplinary Teams

Communication with interdisciplinary teams helps nurses to elaborate a multidisciplinary approach to a patients situation and unite professionals together to create an integrated treatment plan. It might also be said that for the patient, communication between nurses and professionals helps to get coherent information on the developed treatment when a nurse can explain consecutive steps of the procedure, and the same can do other members of a multidisciplinary team. Scholars suggest that nursing communication enhances collaboration within interdisciplinary teams, improves safety, efficiency, and encourages teamwork satisfaction (Gausvik, 2015). The cooperation of specialists ensures that all methods, interventions, and assessments fit the general plan that is tailored and aimed to address the disease of a patient efficiently.

Conclusion

To conclude, one might say that nurses education, skills, and competencies are crucial for patients well-being and recovery. The scope of nurses practice is changing and expanding as it is expected that nurses will lead the research and development of treatment methods based on objective and broad data collected. It is expected that cooperation with other specialists in the field of medical care will evolve in the direction of improving leadership and innovation competencies that will help patients to get better faster.

References

ADN and BSN Nursing Pathways: What are the Differences? (n.d.). 

American Nurses Association. (2015). Nursing: Scope and Standards of.

Bravo K., Cochran G., & Barrett R. (2016). Nursing Strategies to Increase Medication Safety in Inpatient Settings. Journal of Nursing Care Quality, 31(4), 335341. Web.

Gausvik C., Lautar, Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of Multidisciplinary Healthcare, 8, 3337. Web.

Papandrea, D. (2016). Nursing is in Transformation, and Thats Good for Nurses. 

Practice (3rd ed.). Silver Spring, MD: ANA.

Why is Evidence-Based Practice in Nursing so Important? (2018). 

Introduction

The problem of pressure ulcers presents a significant challenge to health care delivery, and nurses dealing with it should have the most capacity to address it. Patients who are unable to move develop ulcers, which are areas of necrosis and ulceration that occur from the combination of pressure, moisture, and displacement forces (Agrawal & Chauhan, 2012).

It is important to understand that early prevention is essential because the further the condition develops, the higher are the risks of dangerous infections developing and presenting significant treatment challenges. Risk factors for pressure development include more senior age, the impaired circulation of blood, malnutrition and immobilization, lower sensitivity, and fecal incontinence (Demarre et al., 2015). The further discussion will focus on identifying a PICOT question intended to develop an intervention to address the issue.

Main body

• P (population): the target population of patients suffering injuries and significant impairments in mobility, thus unable to move or forced to rest in bed for prolonged time periods;
• I (intervention): the strategy of regular repositioning and turning targeted at preventing pressure ulcers development alongside providing proper nutrition, skin assessment, and incontinent care;
• C (comparison): compared to occasional turning and skin assessments, which occurs in many instances because of the low quality of care in some institutions;
• O (outcome): the reduction of pressure ulcers occur in the target population:
• T (timeframe): within a 120-day period.

Thus, the PICOT question for the project is the following: In a population (P) of immobile patients and those with low mobility, what is the effect of a regular repositioning intervention (I) combined with proper nutrition, skin assessment, and incontinent care as compared (C) to occasional turning and skin assessments, on the reduction of pressure ulcers (O) occurrence in the target population within a 120-day period (T).

The proposed intervention is an evidence-based solution supported by multiple researchers. For example, Yap, Kennerly, Bergstrom, Hudak, and Horn (2017) concluded that in order to prevent pressure ulcers, nurses had to conduct regular skin assessments, ensure that patients comply with nutritional recommendations, and are repositioned as frequently as possible. In the process of patient care, nurses are expected to assess the needs of each patient individually to ensure that the aspects of the proposed intervention cater to the specific risks and peculiarities. Developing trusting relationships between patients and their nurses is at the core of nursing practice that would help practitioners to be more proactive in catering to the needs of their patients.

Conclusion

A nursing intervention targeted at preventing pressure ulcers is expected to benefit the nursing practice in general because it encourages paying more attention to the needs of patients. Nurses act not only as carers but also as advocates and companions because they are the ones to interact with patients the most. Nurses are also educators within the intervention because they will inform their patients and families on appropriate methods of ulcer prevention upon discharge.

Thus, the solution is multi-dimensional and encourages nurses to be more attentive to the needs of their patients. The success of the intervention will be measured by comparing the pre-intervention and post-intervention rates of ulcer occurrence in a given facility. In addition, patient attitudes will be measured in order to assess the effectiveness of nursing care based on their perceptions. Appropriate updates in the intervention will be made upon the assessment of its impact on the target population.

References

Agrawal, K., & Chauhan, N. (2012). Pressure ulcers: Back to the basics. Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India, 45(2), 244-254.

Demarre, L., Verhaeghe, S., Van Hecke, A., Clays, E., Grypdonck, M., & Beeckman, D. (2015). Factors predicting the development of pressure ulcers in an atrisk population who receive standardized preventive care: Secondary analyses of a multicentre randomised controlled trial. Journal of Advanced Nursing, 71(2), 391-403.

Yap, T. L., Kennerly, S. M., Bergstrom, N., Hudak, S. L., & Horn, S. D. (2016). An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long-term Care. Journal of Nursing Care Quality, 31(1), 75-83.

• At first, the nurse should mention that atraumatic care is supposed to minimize the physiological and psychological distress experienced by children and their parents (Perry, Hockenberry, Leonard, & Wilson, 2014). In particular, one should consider the impacts of hospitalization on families. Additionally, atraumatic techniques can help George and Martha overcome their anxiety. It is one of the challenges faced by the parents whose child has been diagnosed with pneumonia. Apart from that, the nurse should note that this technique can minimize the segregation of parents and children because this experience is very disturbing. Overall, these methods can make their experiences more tolerable.
• Additionally, it is necessary to discuss the role of child life specialists. These people can help children adjust to medical procedures that are often very painful. In some cases, their responses can be driven by panic and fear. In turn, child life specialists can alleviate their anxiety. Apart from that, they make parents more informed about the way in which a disease can be managed (Kyle, 2008, p. 56). So, they will feel more confident. It is one of the qualities that they often lack.
• Overall, nurses can take several steps to reduce the physical stress of Libby and her parents. For instance, they can provide the medication that can alleviate the pain experienced by patients struggling with pneumonia. Nevertheless, they should carefully measure the dosage of medication. Additionally, they should offer accommodations for parents who should have a good sleep. In many cases, these people are severely affected by sleep deprivation. This precaution can make them more resilient to other stressors.
• The nurse should note that family-centered care has to achieve several objectives. At first, it is supposed to help a person who struggles with a health problem. However, this technique is also used to assist the relatives of this individual. These people can struggle with various difficulties such as the lack of knowledge about the illness (Kyle, 2008, p. 324). Furthermore, family-centered care enables relatives to become more skilled in the management of this disease. This task is critical at the stage when a patient is discharged from the hospital. Overall, this approach can significantly empower families. It can benefit the parents of a child who sustained the fracture of the thigh bone.
• A nurse can apply several verbal strategies to assist Jacob and his parents. At first, they need to avoid the use of medical jargon that often seems confusing and disquieting (Kyle, 2008, p. 258). For instance, parents may not understand such a word as the femur. Instead, one should apply its equivalent, the thigh bone. Additionally, this medical worker should not use the words that can disturb the child or his relatives. For instance, such an adjective as serious may imply that the boy will be permanently crippled. Furthermore, the nurse should rely on the non-verbal communication. In particular, hugging, touching, and caressing can be very helpful. These techniques can produce a soothing impact on the child. Moreover, nurses should use gestures to describe the actions that they are going to take. In many cases, children or their parents cannot understand medical terminology. In turn, non-verbal communication is helpful for alleviating their anxiety.
• Health literacy can be defined as the ability to find, analyze, and understand the information about various issues such as treatment, diseases, and other issues related to medicine. This nurse can apply different methods to explain different aspects of Jacobs care. This medical worker should involve the parents in the process of treatment. For instance, they need to observe the exercises that should be done by people who sustained the fracture of the thigh bone. Moreover, it is necessary to discuss every potential risk to which this child can be exposed.

Reference List

Kyle, T. (2008). Essentials of Pediatric Nursing. New York, NY: Lippincott Williams & Wilkins.

Perry, S., Hockenberry, M., Leonard, D., & Wilson, D. (2014). Maternal Child Nursing Care. New York, NY: Elsevier Health Sciences.

Abstract

The following paper analyzes a scientific article devoted to the problem of nursing education and expertise in which the authors hypothesize on the dependence of the latter on the workplace environment. The authors use a secondary dataset analysis to determine whether there is a positive association between the workplace environment, the staffs proficiency, and the nurses expertise; although the results do not conform to their expectations, the article is valuable in terms of its implications for future studies. The following analysis addresses the purpose, the hypothesis, the materials and methods used in the research; an evaluation of the results is also provided.

Introduction

The article under analysis is devoted to nursing expertise which is the basis for qualified healthcare. The purpose of the work is to assess the ways in which the workplace environment impacts the expertise of individual practitioners. Under the environment a set of contexts is understood, particularly the levels of training and service background of the colleagues and the workplace atmosphere. To estimate the impact of the contexts on the practitioners expertise, the authors used the model that included several ways of context influence mainly concerning interaction. No particular interaction mode was analyzed; on the contrary, the authors preferred to refer to them as a single pattern which, combined with an advantageous workplace atmosphere, would boost the practitioners professional development (McHugh & Lake, 2010). A hypothesis was put forward that nurses surrounded by skillful and educated colleagues in an atmosphere of competence and knowledge were likely to expose higher levels of expertise themselves. A prediction was made that the staffs professionalism could serve as a basis for the nurses training through constant information exchange.

Materials and Methods

Developing a theoretical framework for their research, the authors firstly had to conduct a review of literature to define some basic notions to work with. Firstly, the concept of expertise was delineated as a combination of theory and practice in clinical decision-making. Secondly, the idea of experience was differentiated as the ability to refer to ones own practical background. Although it is not indispensable, it is stated that the atmosphere in healthcare establishments where the staff lacks experience tends to be more stressful. As a consequence, the authors deemed it necessary to take experience as a context variable, as well as education. The latter was delineated as a variable because research has shown the negative association between mortality rates and the practitioners education levels. Another variable was the workplace atmosphere; a collaborative environment with established communication can be positively associated with the nurses acquired skills.

To determine the association between the individual and context variables, a method of secondary dataset analysis was used. The authors relied on the data retrieved from a survey involving a cohort of acute-care nursing practitioners over Pennsylvania. The inclusion criterion for the hospitals sample was that the number of surveyed practitioners was at least 15. The final sample, thus, consisted of 8,611 nursing practitioners. The gathered data consisted of self-reported expertise level of each practitioner and a questionnaire where the respondents were asked to characterize the environment they worked in.

The results of the questionnaires were primarily descriptive. They were further analyzed using a proportional odds model which is the most optimal with variables that are categorical-dependent. Another reason such model was chosen was that it tackled the overall issue of correlated assumptions and simultaneously provided a detailed and precise model of dependent variables.

Research Results

As it was stated, the overall sample size was 8,611 practitioners, the majority of which were women with a mean age of 39. The average practical background was 13.2 years, with 38% of practitioners having an educational degree no lower than baccalaureate. In their questionnaires, the nurses had to evaluate the workplace environment of their healthcare establishments. The estimation ranged from favorable to unfavorable, with an intermediate characterization. This mixed workplace atmosphere was attributed to more than 60% of institutions.

The study revealed there was a positive association between the nurses education level and expertise. It was also found out that education serves as a significant factor of improving the general level of proficiency within each particular institution. The more nursing baccalaureates were practicing within an institution, the more practitioners were self-reporting as Advanced. On the other hand, the authors prediction did not prove true. Despite the fact that there is a solid body of literature evidentiating the correlation between the practitioners expertise and healthcare quality, there was no association found between the workplace atmosphere and the expertise. The authors explain the lack of proof to their hypothesis by assuming that the PES-NWI test the questionnaire was based on failed to encompass all factors influencing the practitioners acquired skills. In addition, no association between the practical background and expertise was discovered. The authors explain it by the fact that they only measured experience by duration while the practitioners actual practice exposure is a crucial factor, at that. As their recommendations, the authors enlist promoting education, particularly BSN, among nurses, describing the means of achieving a higher educated practitioners rate within healthcare institutions.

There are some limitations to this study. Firstly, a secondary dataset analysis was deployed which could potentially increase the error. In addition, the data was retrieved from a cross-sectional study; such design provides high-quality evidence but is insufficient in causality prediction. Also, the findings cannot be generalized since the sample represented state population, not exceeding the borderlines of Pennsylvania. Also, the initial study was accomplished in 1999 meaning the data is still more distant.

Conclusion

To conclude, the given study appears a credible piece of scholarly writing. The investigators have produced solid work the results of which might have considerable implications for future research in the field of nursing education. The theoretical framework developed by the authors is extensive, encompassing and subsequently differentiating such concepts as expertise, education, professionalism, etc. The authors use a dataset involving a sample of more than 8,000 participants; such approach can be considered appropriate since a more extensive sample facilitates the exactitude of the study. The authors show their professionalism as researchers deploying the proportional odds model and successfully operating variables. The results of the study have proved unexpected for the authors but they have accepted the result as it was without trying to manipulate the data, which is yet another credibility factor. More importantly, the results of the investigation might suggest the preceding research on the subject of nursing proficiency as associated with the workplace environment is outdated by now. Before making such a conclusion, however, the possible limitations need to be considered, which is what the authors do. The scope of the study, the extensive sample size, the robust data analysis method and the conscientious acceptance of the hypothesis failure make this article a valuable piece of writing.

References

McHugh, M., & Lake, E. (2010). Understanding clinical expertise: nurse education, experience, and the hospital context. Research In Nursing & Health, 33(4), 276-287. Web.