All professions have regulations that bind their members and the public to facilitate easy delivery of services and enhance productivity. These codes must be respected since they reflect the mission, vision and aspirations of different professions. Critics have argued that the medical profession has many codes compared to others. This is attributed to the fact that this profession deals with human life that is irreversible and thus must be taken care of at all costs (Fisher 2009). Informed consent is a medical code that must be observed by medical practitioners.
Background
Informed consent means more than just signing forms and agreement documents between medical practitioners and patients’ families. Initially, the medical profession was clouded with court cases regarding improper professional conduct in handling patients due to misunderstanding and confusions between patients and doctors (Fisher 2009). There were no rules and regulations to outline agreements with them. To date, informed consent has made it possible for doctors to carry out risky medical operations without fear. This term used to refer to a form signed by patients, their families and doctors outlining various medical processes involved in treatment (Corey 2011). Today, the term refers to all processes involved in educating patients and their families about various medical procedures. This lifts blame from doctors in case anything unexpected happens to patients.
Obtaining Informed Consent
Most medical institutions including the American Psychotherapist Association identify three major processes involved in obtaining informed consent. These aspects include willingness, rationale and information (Fisher 2009). Information refers to all aspects the patient needs to know before undergoing any medical examination or treatment. It is important to put everything in its clear perspective to ensure patients understand what they will be going through before, during and after treatment. This may include explanations regarding treatment period, mode of treatment, medical fees, third party participation, policies regarding payments and secrecy.
Willingness refers to all voluntary aspects involved in psychotherapy. It is necessary to observe that patients participate in psychotherapy without being forced to do so. It is important to stress that even though doctors must ensure they protect lives this cannot be done by force. Patients have a right to refuse treatment or cooperation in various aspects.
Thirdly, rationale refers to the consent and agreement that patients understand what is expected from them and that they know what is going to happen before, during and after treatment (Fisher 2009). It should be noted that patients are entitled to all information that affects the treatment process. Therefore, it is necessary to ensure they understand every aspect of the procedures involved. Above all, patients must agree to undertake various psychotherapy processes before doctors decide their next move.
However, there are few exceptions to the above conditions that make the process of obtaining informed consent not applicable as is expected.
First, children cannot make rational decisions and this means that someone else has to step in their place and represent them (Corey 2011). Parents and guardians are usually better placed to represent children in this aspect. Secondly, mentally challenged people cannot make rational decisions and this means that their guardians must take full responsibility in obtaining informed consent. In addition, terminally ill people and those in commas may not be in positions to make correct judgment and this means someone else must step in and agree to the terms and conditions involved in their treatment.
Lastly, very old people are usually not in positions of making correct judgment; therefore, there must be someone to assist them (Corey 2011). However, it is also important to stress that people obtaining informed consent on behalf of patients must have close relations with the patient. They may be parents, spouses, guardian or very close family members.
Differences between Informed Consent and Assent
The difference between informed consent and assent is very minor and most people confuse these terms. Assent refers to situations where patients are not old enough to make informed choices (Fisher 2009). For instance, children cannot make informed consent since they are considered to be minors. Additionally, very old people and those suffering from mental problems cannot be allowed to make this choice since their mental conditions are usually incapable of making rational decisions.
In the above cases it is advisable to get someone else to make an informed choice on their behalf. However, the most important part is to understand that the above patients must agree that they understand what is about to happen to them. Therefore, their representatives must explain to them what is happening and seek their permission before any process begins (Corey 2011). This means that as much as patients may not sign the consent form they must assent to the process. Their representatives should sign the forms after being informed about the anticipated processes.
The most important thing to know when obtaining informed consent is that all parties must be informed about the expected processes, their duration, cost and must also agree that they are willing to participate in that process.
Conclusion
Medical practitioners should do everything within their abilities and skills to protect human life. However, responsibility for any accidents should not be placed on doctors and this means patients and their families must make informed choices before any procedure begins. There must be understanding of all concepts, procedures and fees involved before a consent form is signed.
References
Corey, G. (2011). Issues and Ethics in the Helping Professions. California: Thomson Brooks.
Fisher, C. B. (2009). Decoding the Ethics Code: A Practical Guide for Psychologists. California: Sage Publications.
In their professional practice, nurses are forced to deal with many aspects; workforce issues and patient safety are among them. These phenomena can have different characteristic features from site to site. That is why it necessary to conduct profound research to identify the main peculiar features of the two. Thus, many scholarly articles are designed to analyze relationships between workforce issues, patient safety, and the nursing profession.
Research Analysis
To begin with, one should note that the phenomena above can be correctly assessed with the help of credible and evidence-based studies (Burns & Grove, 2015). Firstly, the topic of nursing workforce issues is a central research question of a survey by Kovner et al. (2018). The scientists mention that nurses face the issues of diversity, obtaining bachelor’s degrees, and inter-professional education. Thus, the objective of the study is “to report the progress” in meeting the things above (Kovner et al., 2019, p. 160). This study arrives at a hypothesis that some successful results have been achieved, but further work is required. Secondly, Boamah, Spence Laschinger, Wong, and Clarke (2018) pay attention to the research problem of patient safety. The researchers’ objective is “to investigate the relationship between a transformational leadership model and patient safety outcomes” (Boamah et al., 2018, p. 180). They utilize a hypothesis that the leadership behaviors of this kind are detrimental for improving the phenomenon under consideration.
Research Evaluation
As has been stated, it is reasonable to consider the results of credible and valid studies only, and the two studies meet these criteria. On the one hand, there were published in 2018, which emphasizes their validity. On the other hand, both articles are evidence-based since they reckon on precise data and statistical information. Thus, one can trust the results found by the authors of the two studies.
References
Boamah, S. A., Spence Laschinger, H. K., Wong, C., & Clarke, S. (2018). Effects of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180-189.
Burns, N., & Grove, S. (2015). Understanding nursing research: Building an evidence-based practice (6th ed.). Philadelphia, PA: Saunders Publisher.
Kovner, C. T., Djukic, M., Jun, J., Fletcher, J., Fatehi, F. K., & Brewer, C. S. (2018). Diversity and education of the nursing workforce 2006-2016. Nursing Outlook, 66(2), 160-167.
Nowadays nursing is an important profession that requires specialists both to have compassion for people suffering from health problems and be highly skilled and knowledgeable. Researchers note that during the 20th century, crucial changes were brought to the sphere (Aligood, 2017). Nursing was recognized as a science, and instead of a traditional model of learning from more experienced nurses, a science-based approach to the training of the would-be specialists in this occupation was implemented (Aligood, 2017). Although working on the improvement of practical skills only with little attention paid to theory might be regarded as the right way to become a professional, theoretical concepts are crucial for the nursing practice.
Knowing the theory is an indispensable prerequisite for a person to be successful as a nurse. According to Aligood (2017), “not only is theory essential for the existence of nursing as an academic discipline, it is also vital to the practice of professional nursing” (p. 7). Indeed, theoretical ideas in the sphere of nursing form a great base for practice because they give specialists useful recommendations and directions and stimulate critical thinking (Aligood, 2017).
Being good at theory can help a nurse to make the right decision on how to communicate with patients in a particular situation or how to act in an emergency case. Sometimes, these abilities of a specialist might play a key role in a patient’s restoration to health and strength or even save lives. Hence, it is possible to note that the skills motivated by theory have a significant part in a nurse’s effectiveness, which, in its turn, is crucial to public health safeguarding (Smith & Liehr, 2018). For this reason, learning theoretical concepts is an integral part of nurses’ education that has a great influence on their practice.
Throughout his or her career, a specialist in the field under analysis should also pay attention to theory in order to be able to address the needs of the changing world. In fact, medicine is constantly evolving, new technologies and methods of treatment are being implemented, and it is very important for a nurse to be informed about them (Aligood, 2017). For many situations, a general understanding of processes and ideas, not just an ability to conduct specific operations, is required (Ray, 2020).
Such comprehension can only be achieved if a person has acquired high-level knowledge of the theoretical framework. Using a system of assumptions, ideas, and hypotheses provided by theory a specialist can speed up his or her professional development and easily get used to the new techniques and approaches in medicine (Ray, 2020). Hence, a nurse’s possessing theoretical information and getting more knowledge might be vital to their long and successful career and fulfillment of professional responsibilities.
To sum up, it is important to press the point that the profession of a nurse has changed significantly over the last century. In the education of nurses, the focus has been shifted from the experience of previous generations of specialists to the scientific approach and knowledge. Indeed, theoretical ideas, concepts, structures, and hypotheses are crucial to the practice of a nurse. The reason is that knowing and understanding theory serves as a basis for practice and is to be applied to patient care. Besides, it helps a professional to address the changing needs of the modern world and have a long career.
References
Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). St. Louis, MO: Elsevier.
Over the years, many people get a negative attitude towards dentists and dentistry in general. This happens because even 20 years ago, the quality of medical services was significantly worse. However, now the situation has changed considerably, and visiting a dentist can be as comfortable as other doctors. Researchers state that if people “are embarrassed by the appearance of their teeth when they smile, then they cannot be said to e have true oral health” (Chestnutt 5). Despite this, many people are still not into this area of medicine and are afraid to treat their teeth.
The consequences of this attitude to health can be severe. Firstly, without a regular health check, people may not be aware that they have caries or other problems. Secondly, when patients come to dentists at the last stage of the disease, there is not always a chance to cure it. Besides, this complicates the treatment and makes it more expensive. The purpose of this paper is to consider ways that can make dentistry more attractive and acceptable to the public.
Availability
The availability of health services plays a crucial role in the whole medication process. This factor includes many aspects, the combination of which gives a result. First of all, a dental clinic should have a good and structured website. With its help, potential customers will be able to find out about all available services, get to know doctors, and see prices. Also, the website should have an application form: in the 21st century, people don’t like to call at all, thus, it will be easier for everyone. On the one hand, a patient will not have to waste time to a call. On the other hand, it will be convenient for administrators to receive all the patient information through the website immediately.
Also, transport accessibility is essential as well, just because it simplifies the process of visiting a doctor. Undoubtedly, the cost of rent depends on the location, so it is necessary to assess the ratio of price and quality correctly. It is possible to find a very convenient and prominent place even far from the city center. To make it even easier, it would be useful to create a signboard that attracts people’s attention. Thus, patients will not need to spend a lot of time and effort to get to their dentist.
Communication
An essential aspect of any service is communication with customers, and dentistry is no exception: before coming to the appointment, patients communicate with administrators several times. This means that these administrators must be trained in the correct approach to patients. They should understand that people come to them to treat something, so they need to be handled with care. Administrators need to be friendly and helpful, and they must also have an excellent knowledge of the range of services and their prices. If patients know for sure that the clinic treats him well and hires only professionals, they will be much more disposed to it.
Details
In many areas of life, it is vital to pay attention to details, and medical services are one of these areas. The patient will be much more pleased to visit a clinic with a neat and beautiful repair than an old hospital. There are countless things to work on: convenient lockers for personal belongings, a TV on the wall, a room for children, a vase with sweets at the reception. All these small things help to create a good impression on the visitors. If the clinic establishes an atmosphere of comfort and coziness, then patients will be much calmer to be there. Even knowing that they will have a complicated treatment, they will feel the care.
Bonuses
Medicine often requires significant investments, so another way to make it more enjoyable is to create a bonus system. There are many different options for this, for example, seasonal offers, discounts on comprehensive services, or reduced prices for regular customers. In dentistry, this system should be carefully worked out so that it is attractive but adequate. For example, a regular customer should be considered not one who visits the clinic every two weeks, but one who regularly checks the health condition for several years. With this approach, people can feel the benefits of visiting a dentist. Even if they have not yet been to a particular clinic, they will see that it offers favorable conditions for patients.
Conclusion
There are many ways to make dental services attractive to patients. In addition to the items described, it is worth paying attention, for instance, to marketing. Most likely, for the first time, customers will see information about a clinic in some advertising, so its high quality is necessary. This will already have a positive effect on the image of the company and will inspire people’s trust.
However, the most significant aspect of dentistry is the treatment itself. Most important for patients is how the doctor communicates with them and what results they get. People often advise doctors to each other, and this type of advertising means much more than any other. A combination of quality medical services and all the other items described will make a dental clinic the most popular and successful.
Work Cited
Chestnutt, Ivor G. Dental Public Health at a Glance. John Wiley & Sons, 2016.
In the nursing profession, nurses are required to offer quality and professional services to patients; nursing ethics require practitioners to do much they can to facilitate patients’ fast recovery. Healthy nutrition is an important part of the recovery process; it offers patients the right quantities of macronutrients and micronutrients necessary for fast recovery. This paper discusses how I (nurse) can use nutrition in my profession.
Discussion
Nurses take care of different patients suffering from different diseases, depending on the disease, there may be some food that can be more beneficial to a patient while others may not be; on the other hand, some patients have conditions that does not limit them from using any kind of food.
When offering nursing services, it is of crucial importance to recognize the differences in the categories of patients so that when making feeding decisions, the right combination is used. For example, when dealing with a malnutrition case, nurses should be more on macronutrients that contain calories (energy): proteins, carbohydrates, and fats, to the patients, when such foods are used, they are more likely to facilitate quick recovery and quality services.
When a nurse is dealing with liver problems, the main issue to consider is how to intoxicate the liver, some foods can be used alongside the medications to facilitate the healing process, they are foods that will detoxify the liver. In the same process, if such a patient is given food with high contents of spices and chemicals, then the recovery may be delayed.
Dealing with the nutrition only is in itself a standing profession that can earn someone a living; different situations, health status, age, and activities requires different nutrition for their effectiveness; this opens a chance of an opportunity to consult people for a living.
However, coming to the picture of nurses, other than offering the nursing care at hospitals, nurses should advise their patients and their caregivers, in the hospital or when at home, on the right food they should give their patients and by extension the family. Doing this fulfills the noble goal of improving health among communities. The nurse will be acting ethically and using his/her profession to add value to the community.
An old saying states that “we are what we eat”, this means that if people were to eat healthily, then society would have an improved living conditions. Healthy nations are far more productive than one that does not have the quality of life; in such nations, the government will focus on improving the living conditions other than providing basic health facilities.
When nurses invest in giving the right nutritional food to patients according to their health conditions, then the patients are prone to benefit in a variety of ways they include:
Patients will have a quick recovery from disease: other than hunger satisfaction, food have the medicinal benefit to the body so when the right food is given then patients will recover fast
Healthy eating will lead to improved health to a patient; this is when followed after leaving a health facility, nurses should offer patients advice on the right food they should take after leaving the hospital
From a macro level, when nutritious foods are eaten, they can prevent some diseases thus improving health conditions among communities
Conclusion
For healthy living, human beings need to eat nutritious foods; this is whether someone is sick or not. When one has eaten healthy, his/her immune system is boosted making him/her healthy; a healthy nation is a productive nation. Nurses should ensure their patients are fed the right nutrition to facilitate their recovery.
Earlier centuries nursing care was disorganized, unsanitary, and lacking in scientific foundation (Sarkis and Conners, 1986)
The modern definition of Nursing: A science and an art that focuses on promoting quality of life as defined by persons and families, throughout their life experiences from birth to care at the end of life (Wikipedia, 2009)
Nursing Profession
Focused on assisting individuals, families, and communities in attaining, re-attaining, and maintaining optimal health and functioning (Wikipedia, 2009)
Modern nursing is changing with new roles and working practices. Nursing which is traditionally known as being a caring profession is also changing and has been replaced by a computerized system (Watson, 2002).
Important quotes about nursing
“The real challenge in nursing is to have an intimate moment of compassion with the patient….”
“Nurses should guard caring as they guard their freedoms.”
“The reward in nursing is patient care.”
Nursing is an art; and if it is to be made an art, It requires as exclusive a devotion, as hard a preparation as any painter’s or sculptor’s work; For what is the having to do with the living body—the temple of God’s Spirit? It is one of the true Fine Arts; I had almost said, the finest of the Fine Arts.” –Florence Nightingale
Florence Nightingale
In 1860, she established the Nightingale Training School for Nurses
As a result, many nursing studies from the 1950s to the present reflect the influence of psychology, sociology, anthropology, and education. With the advance of health technology in the 1960s, nurses were faced with the need to understand many new therapies, pharmaceuticals, and advanced electronic monitoring systems. Since the nursing profession became more important one has appreciated the relevance of having its literature and information system (Sarkis and Conners, 1986).
Nightingales ‘7’ basic tenets were that:
The content of nursing education must be defined by nurses.
Nurse educators are responsible for the nursing care provided by students and graduates of the nursing program.
Educators should be trained nurses themselves.
Nursing schools should be separate entities, not connected with physicians or hospitals.
Nurses should be prepared with advanced education and should engage in continuing education throughout their careers.
Nursing involves both sick nursing and healthy nursing and includes the environment as well as the patient (holism).
Nursing must include theory.
Late 19th Century, 20 Century to NOW
Nursing care increased with the Civil War
Clara Barton – founder of American Red Cross
Bellevue Hospital -1873 set out on the New York Training School fabricated after Nightingale school
Linda Richards – first U.S. Trained nurse, 1873
Mary Mahoney – first black nurse trained in 1879
During WWI nurses were integrated into the wounded recovery plan but without much recognition
During WWII nurses status was elevated to officer status
Nursing Education
Formal nurse education in the United States and Canada directly followed the Nightingale model of hospital-based training and upon graduating, students earned a Diploma in Nursing.
During the 1920s a shift to education in academic facilities began and now nurse education is primarily conducted within colleges or universities/universities with clinical classes held in hospitals. However, some hospital-based schools persist.
Nursing: 1990’s to Now
Health education added to school nurse role
Medical Examination
Exploration for physical defects
Concentrate on case finding and disease limitations
Ignores all preventive aspects of health
Nursing Education Changes
The Goldmark Report was Published in 1923
This report argued nursing to be on an equal footing with other disciplines. Secondly, it also emphasized nursing education to take place in the university setting.
1941 – National Association for Practical Nurse Education (NAPNES) was founded to address the needs of practical nurse education
1944 – Increased interest in a preventative aspect of school nursing
1945—Freeman identified 4 major changes as having implications for school nursing
1949—Sixteen state Departments of Education require teaching certificates to work in schools; four other states require a certificate if the nurse taught any classes
1950—Expansion and development of programs and priorities established in the 1940s:
“Health is the first objective of education”— generally accepted
Technology and Nursing Practice
The current healthcare environment reproduces an increased difficulty in client needs and rescue systems and requires various levels of nursing educational training
Computer and information technologies in health care increase at a faster rate and this is, in turn, improve the nursing practice and patient education
Modern teaching approaches with new technology-based teaching and learning assignments will increase student attainment, including retention, motivation, and class participation; improve learning and significant thinking, provide instructional reliability, and augment clinical education (Gustafson and Shuyler, 2003).
Support of educational institutions, accrediting bodies, credentialing organizations, regulators, and licensees is essential to produce the best result for the health care of the public (National Council of State Boards of Nursing, 2002).
Certification as a regulatory mechanism is used to signify that an individual has met state-recognized requirements that include a study of fitness in an area of advanced clinical nursing practice.
This technique limits practice within the area of expertise to those nurses who hold such a license. It would have the potential for limiting generalist practice and the normal development of basic nursing practice (NCSBN, 1986).
Present needs of the healthcare industry
The requirements for Registered Nurses are increasing regularly at a faster rate
Strategies can be accomplished while upholding high standards for nursing education. (Krautscheid and Burton, 2003).
Fast shifting genetics methodologies and capabilities have urged the formation of secondary scientific fields of study to produce powerful tools to advance genomics, functional genomics, and proteomics.
New roles in nursing must develop in ways that promote superiority in client-centered care and that are in the public’s best interests. At the same time as nurses move along the continuum of experience and education, they obtain additional competencies that are integrated into their practice. This enables nurses to contribute to the health care system in new ways (CAN, 2002).
Nursing Shortage
Existing staff is under the pressure of working overtime.
A study conducted by Aiken and his associates showed that trends in hospital use and staffing patterns have brought together so many problems especially related to hazardous conditions for patient safety. The study exposed the fact that high patient perception levels, collectively with a raise in admission and discharge cycles and less number of nurses pose serious challenges for the delivery of safe and effective nursing care (Aiken, et al., 1996).
In emergency units, twenty-four-hour shifts are becoming more common (Rogers, et al., 2004).
Working extra hours creates stress in the nursing staff and may end in medication errors
Increased numbers of healthcare professionals in the nursing profession are needed not only to care for elderly patients but also to replace retiring professionals.
Conclusion
The Healthcare sector is shifting rapidly
The use of computer and information technologies in healthcare increase at a faster rate and this is, in turn, going to improve the nursing practice and patient education
The use of a computerized charting system can help the nurses in managing the data.
Stress management strategies can help the nursing staff
Cognitive-behavioral interventions and relaxation or meditation strategies have proven to be successful in reducing personal levels of stress (Mimura and Griffiths, 2003).
The government and healthcare industry need to work on strategies to improve the present situation.
References
Aiken, L.H., Sochalski, J. and Anderson, G.F. (1996) Downsizing the Hospital Workforce, Health Affairs 15, no. 4, pp 88–92.
Canadian Nurses Association (CAN), (2002) Advanced Nursing Practice. Position Statement. Canadian Nurses Association, Ottawa. Sarkis, J.M. and Conners, V.L. (1986) Nursing research: historical background and teaching information strategies. Bull Med Libr Assoc. 1986; 74(2): 121–125.
Gustafson K. and Shuyler, K. (2003) A Case Study: Knowledge Management Systems to Enhance a Nursing Curriculum. Poster Presentation at the 36th Annual Communicating Nursing Research Conference/17th Annual Western Institute of Nursing Assembly in Scottsdale, Arizona 10-12, 2003.
Krautscheid, L. and Burton, D. (2003) Technology in Nursing Education. [Online], Oregon Centre for Nursing. Web.
Mimura, C. and Griffiths, P. (2003) The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review, Occupational and Environmental Medicine, (60)1.
National Council of State Boards of Nursing (2002). Regulation of Advanced Practice Nursing. [Online], 2002 National Council of State Boards of Nursing Position Paper. Web.
Informatics in the nursing profession is the use of the modern system of science and technology in acquiring knowledge in regard to better caregiving to the patients. (McGonigle & Mastrian, 2015). Information technology usually requires a person to have knowledge in computer science. Nurses, therefore, need to access knowledge in computer and information technology as the basis for enhancing information transfer. The computers need to be fitted with internet accessories for the ease of sending and receiving information. The nurses too will need to be computer literate for them to utilize the modern means of acquiring information (Choi & De Martinis, 2013). When this is met, nurses can get the information via mail, internet conferencing and other electronic means of communication. The ease of communication between nurses will enhance the information regarding taking care of the patients.
Electronic health record (EHR) is the use of computer in recording the health history of a patient. The electronic storage has both the good and the bad effect of the patient information. A benefit of the EHR information system is that the patient information can be generated in a specific period and help in managing the disease. Secondly, the transfer of information is easier as nurses can easily send them to another caregiver where a need for consultation arises (Choi & De Martinis, 2013). The process is possible and also improves the quality and privacy of storing patient information. On the other hand, a risk of outsiders engaging in the information system the access to the information by unauthorized people (McGonigle & Mastrian, 2015). The effect can arise when the nurse forgets to move from the information page when leaving the office room.
The government, via the legislative authority, has enacted several laws that would help in the development of information and technology in the nursing profession. One of the acts is the HITECH that gives us as nurses to freely develop our profession via the study and use of information technology services. The HITECH Act guarantees the nurses a go ahead with the quality improvement by the use of IT in sharing information and storing important patient information (Choi & De Martinis, 2013). On the other hand, the Act offers difficulty penalties on nurses who use the information Technology in ways that might lower the esteem of the patients (McGonigle & Mastrian, 2015). The law thus acts as a watchdog on the nurses’ use of information technology.
The electronic health record allows patients to have access to their health records. A provision by the law that enables the patient to have access to their records is both beneficial and risky to patient’s health management (McGonigle & Mastrian, 2015). The benefit that the nurse accrues is that he or she can follow the disease history and make an inquiry on some issues that may not be clear in the records. They can also change the strategies when the previously used fails to bring a positive impact on the patient’s recovery. On the other hand, the access of the information may result in the distortion of the data from the patient. When this happens, the nurse in charge will be confused and diagnose the patient wrongly (Choi & De Martinis, 2013). The issue may result in poor recovery or even death of the patient.
References
Choi, J., & De Martinis, J. E. (2013). Nursing informatics competencies: assessment of undergraduate and graduate nursing students. Journal Of Clinical Nursing, 22 (13/14), 1970-1976.
McGonigle, D., & Mastrian, K. (2015). Nursing Informatics and the Foundation of Knowledge. Burlington, MA: Jones & Bartlett Publishers.
A nursing theory is a framework developed to organize knowledge and define the discipline more clearly (Cowden & Cummings, 2012). The suppositions promote quality patient care and provide solutions to various problems in the nursing practice. The theories are used to resolve challenges in both educational, research, and administration settings. In addition, they are applied when directly helping patients.
In this paper, the author will analyze middle-range theories and their application in the nursing profession. The conjectures are more concrete and narrow compared to grand theories (Cowden & Cummings, 2012). The reason behind this is because they contain a limited number of variables and prepositions. In spite of this, they can be used to resolve a wide range of clinical research queries. There are a number of middle-range theories in the nursing discipline. One of the most commonly used includes Orlando’s supposition of the nursing process. Another one is Watson’s theory of human caring. There is also Peplau’s model of interpersonal relations.
In this paper, the author will discuss how middle-range theories can be used by leaders and managers in the nursing profession to improve patient satisfaction and care delivery. A number of problems and issues in nursing will be discussed. Under each problem, a strategy that can be used to resolve it will be provided. In addition, there will be an analysis of ethical concerns in the profession. Other aspects to be discussed include models of leadership needed to enhance staff engagement and how middle-range theories can be applied in community settings.
Analysis of Problems and Issues in Nursing and Strategies to Resolve them from the Perspectives of Middle-Range Nursing Theories
The Issue of Patient Satisfaction and Improved Care Delivery
In the healthcare field, nurses work their level best to promote patient satisfaction and improve the quality of care provided. In spite of these efforts, they face challenges that may negatively impact on their ability to offer quality services (Kalish & Lee, 2011). One strategy to deal with the problem involves the use of the theory of nursing process. In the framework, Orlando stresses on the need for a reciprocal nurse-patient relationship. To this end, the major goal of healthcare providers is to identify and meet the immediate needs of an ailing individual (Longo, 2010). However, before making decisions, the practitioner should determine the patient’s behaviors and need for help. In addition, nurses should offer their services to people within any setting.
One ethical issue related to the application of this strategy is the need to enhance patient involvement. The theory also encourages patients to participate in the nursing process. One way of doing this is by effectively communicating their needs in instances where they are not critically ill and can initiate a conversation. When nurses use this model, they gain more knowledge on how to deal with patients’ needs (Longo, 2010). As a result, they improve quality of care and patient satisfaction.
Recently Publicized Ethical and Legal Concern in Nursing Profession
Overview
Ethics entails doing the right thing and causing no harm. However, different nurses have their own definition of what is ethical. In the nursing field, care providers are faced with ethical problems that affect them and their patients (Kalish & Lee, 2011). In spite of the frequent nature of the cases, majority of them attract little attention or go unnoticed.
One recently publicized ethical and legal issue in the nursing field is the Stoughton elder abuse case. The case involved a 75 year old lady under the care of a registered nurse. The practitioner was Sandra Lucien-Calixte. The lady was kept in a frosty basement room in Palisades Circle. She had sores, was malnourished, and dehydrated (Erwin-Toth, Thompson & Davis, 2012). According to Stoughton Police reports, Sandra was a healthcare provider recognized by the Commonwealth of Massachusetts. She was an employee of the Spaudling Rehabilitation Hospital. The thermostat in the room was set at 51 degrees. The old woman’s bed sores were so severe to the extent that some of her bones were exposed (Erwin-Toth et al., 2012). Upon rescue, the victim was immediately taken to the ICU.
Analysis of the issue from the perspective of human caring and process discipline theory
Watson’s theory of human caring is based on various principles. They include a relational caring for both self and others. To this end, nurses are required to base their practice on moral, ethical, and philosophical foundations of love and values. In addition, they should employ a reflective approach when helping patients (Cowden & Cummings, 2012). Orlando’s theory stresses on the need for a nurse to meet the patient’s immediate needs. When a healthcare provider helps an ailing individual, the purpose of nursing is met (Longo, 2010).
A review of Sandra’s case from the two theories reveals that the practitioner violated the nursing code of ethics. She failed to offer her help to the old lady as was required. Despite of her knowledge of the victim’s predicament, she chose to keep the elderly lady in a poor state. The situation could not facilitate her recovery.
Administrative Concerns in Nursing Profession
The problem
Disruptive behaviors in the healthcare profession impact negatively on the safety of both patients and staff. The issue is a major challenge in the nursing field. However, most cases are never recognized or reported. Managers and leaders should develop initiatives to address the problem. Failure to deal with unruly behavior silently encourages and reinforces it (Longo, 2010).
One major administrative concern is nurse bullying by co-workers, such as managers. The predicament has remained a major issue in the field for decades. The conduct is both threatening and humiliating. In addition, it interferes with care provision. For example, in the United States, one out of every six employees suffers from bullying. Research studies by National Surveys indicate that approximately 27% to 85% of nurses report being bullied in the workplace. New employees are at higher risk compared to their established colleagues. About 90% of them have experienced some level of hostility from co-workers (Kalish & Lee, 2011).
Resolving the issue of nurse bullying by use of oppressed group behavior and human caring theories
Many theories have been used to explore behaviors in the nursing profession. The two models that can be used to address the problem of bullying are oppressed group behavior and human caring suppositions. The latter supports the development of authentic caring connections and relationships in the workplace (Cowden & Cummings, 2012). When employees have healthy associations, their performance improves. According to the oppressed group behavior theory, nurses are members of the exploited faction. They are unable to confront the oppressive system (Longo, 2010). As a result, the healthcare providers take out their frustrations on each other. An analysis of the problem from the perspective of the two theories reveals that nursing leaders should be at the forefront in ensuring the work environment is safe for all employees.
Nursing Leadership and Staff Engagement
Leadership is another major issue in the nursing profession. It is noted that the style adopted by administrators has impacts on both employees and patients. Poor management affects the morale of employees. It also increases turnover rates and reduces productivity. As result, the quality of care is unsatisfactory (Longo, 2010).
Democratic leadership can be adopted as a strategy to address this concern. The model encourages all employees to take part in the decision making and goal setting process (Cameron, Harbison, Lambert & Dickson, 2012). Before making decisions, a nursing manager gathers information, ideas, and feedback from employees. However, the final decision is made by the leader. Democratic managerial approach also facilitates professional and personal development among nurses. In addition, the employees acquire some level of autonomy. The model motivates them to take initiative and make contributions to matters related to their profession (Cameron et al., 2012).
Using Nursing Intellectual Capital Theory to Deal with Staffing Issues
Staffing is a major administrative matter that nursing managers need to address. Registered nurses acknowledge that enrollment is a major concern (Kalish & Lee, 2011). The problem affects both patients and healthcare providers. Studies reveal that there is a link between nurse-to-patient ratio and quality of care.
The concepts found in nursing intellectual capital theory help in the understanding of work environment (Cowden & Cummings, 2012). It encourages the development of strong inter-relationships among all aspects of the healthcare setting. They include staffing levels, managers’ support for all employees, and recruitment of registered nurses. Application of this theory by managers has numerous benefits. They include reduced medical errors, decrease in mortality rates, and improved patient satisfaction. In addition, nurse fatigue is reduced.
Early Discharge before Adequate Education on Ostomy Care
In North America, over 70,000 patients undergo ostomy surgery annually (Erwin-Toth et al., 2012). The operation can be conducted at any age. It can also be permanent or temporary. The procedure is necessitated by such ailments as cancer and congenital. The intervention affects patients in different ways. For example, they experience changes in bowel routine, sexuality, and social activities. Under the care of nurses, ostomy patients are taught on how to cope with the condition once they are discharged. However, not all patients undergo the entire training process.
To help reduce cases of early discharge, nurses can employ Peplau’s theory of interpersonal relations. The supposition provides a framework for patient training. It stresses on the need for a healthy nurse-client relationship. The therapeutic correlation allows a healthcare provider to provide the information needed to understand the diagnosis and treatment plan (Cowden & Cummings, 2012). Through this, the patient is able to undergo the required recovery process. In addition, they regain their normal state of independence and enjoy quality life.
Application of Middle-Range Theories in Third World Countries’ Community Settings
Nursing at the community level in developing nations has both advantages and limitations. Challenges emanate from the poor working and living conditions in certain parts of the countries (Cameron et al., 2012). In addition, some locals are hostile and unwelcoming towards foreigners.
Concepts from nursing theories offer a wide range of benefits to healthcare providers when working in different places. Nurses get important information that enables them to develop strong relationships with patients from varying backgrounds. They also gain the capability to work with the communities by taking the necessary steps to acknowledge prevailing morals and beliefs (Kalish & Lee, 2011). In addition, healthcare providers acquire more knowledge to help them devise plans on how to help patients in the worst affected areas. Consequently, the practitioners end up improving the peoples’ quality of life.
Using Clinical Systems Improvement Theory to Enhance Flow of Patients in Hospital Settings
Waits, delays, and cancellations have become a daily routine in healthcare settings. Flow involves the movement of information, patients, and equipment between staff in different departments. Hospital areas that are faced with the problem include emergency department, intensive care unit, and operating rooms (Kalish & Lee, 2011). The sections are regarded as bottlenecks because they are non-interchangeable resources.
A middle-range theory that can be applied to optimize patient flow is clinical systems improvement (CSI) model. The framework is an evidence based procedure management for healthcare. It brings together knowledge from psychology, systems engineering, and other fields to improve service delivery (Cowden & Cummings, 2012). In addition, the model uses tools and information acquired from other theories. Such models include lean thinking, theory of constraints, and Six Sigma. By effectively applying CSI, healthcare centers can reduce delays and get rid of activities that do not aid in patient care.
Conclusion
In the process of writing this paper, the author acquired new knowledge about nursing theories and their application in the profession. For example, the author realized that nursing is an ever changing and complex discipline. In spite of these transformations, the dedication of nurses to their work continues to change for the better. The professionals have managed to excel by upholding ethical standards and maintaining best practices. In addition, by giving nurses a sense of identity, the wide range of theories in the profession can help patients and leaders in the field to understand the importance of their work. The diverse middle-range nursing theories play a key role in helping healthcare providers improve delivery of patient care.
References
Cameron, S., Harbison, J., Lambert, V., & Dickson, C. (2012). Exploring leadership in community nursing teams. Journal of Advanced Nursing, 78(7), 1469-1481.
Cowden, T., & Cummings, G. (2012). Nursing theory and concept development: A theoretical model of clinical nurses’ intentions to stay in their current positions. Journal of Advanced Nursing, 68(7), 1646-1657.
Erwin-Toth, P., Thompson, S., & Davis, J. (2012). Factors impacting the quality of life of people with an ostomy in North America: Results from the dialogue study. Journal of Wound, Ostomy, and Continence Nursing, 39(4), 417-422.
Kalish, B., & Lee, K. (2011). Nurse staffing levels and teamwork: A cross-sectional study of patient care units in acute care hospitals. Journal of Nursing Scholarship, 43(1), 82-88.
Longo, J. (2010). Combating disruptive behaviors: Strategies to promote a healthy work environment. Online Journal of Issues in Nursing, 15(1), 3.
The main task of this paper is to apply the sociological theory of professions to examine the extent to which health care organizations have the characteristics required to support organizational learning. In this respect, it is necessary to analyze the theory on professions and examine the necessity of organizational learning for the health care staff. I am going to compare the professions and occupations, compare adaptive and generative learning, and include different values that can be beneficial while implementing organizational learning.
People working in the area of health care should be able to make decisions influencing the lives of their patients who are ordinary people; improving the care delivery, it is possible to facilitate relationships between health care staff, patients, and other stakeholders in the complicated problems relevant to human health. Some professions are more likely to encounter difficulties related to little knowledge. Occupations in this respect are treated as human activities that help to gain money and do not require formal education. Degrees and certifications are irrelevant for cleaner and front-door security men.
Health care provision in modern society has been complicated by the emergence of new health needs and an increase in the number of people requiring health services. In addition, there has been a call for an increase in quality and reduction of health services. Besides, technological advancement and the introduction of new health care procedures have been a challenge to health providers. The new challenges call for creativity and flexibility in service provision. Professionalism and organization learning are some of the concepts that are used to overcome modern challenges. The paper examines the usage of concepts of professionalism and organization learning in health organizations.
Characteristics of a learning organization
Although the learning characteristics are exhaustive we are going to examine four of the common which were laid down by Argyris (1991, p. 101): communication and openness; inquiry and feedback; adequate time; and mutual respect and support. A learning organization must adopt a culture of dialogue, communication moves vertically across the organization. There ought to be a high participatory level of all individuals in the organization. An organization that has adopted this culture has a robust flow of communication from the bottom of the hierarchy to the top and vice versa. Inquiry encourages people to adopt an inquisitive culture in course of their duty, this helps them analyze the problem critically and also get insights from others in the organization.
Feedback involves the responses generated from the inquiries made. The learning organization should allocate ample time for the individual to continue the professionalism. This may include the organization organizing in-house training for the health care practitioners (Freidson, 2007, p. 350). This ensures that public care produces the most qualified health personnel. This reduces the overreliance on the private sector and also reduces the exploitation of the patient. The last one is mutual respect and support. This involves appreciating co-workers and all other subordinates who make the discharge of duty successful. It also calls for the senior staff to show respect to the junior officers and vice versa.
Professions about organizational learning
There has been frantic effort to realize the importance of teamwork with some sections opposing and others proposing it. This is evidenced by Bolton et al. (2005) suggesting that teamwork is a subject approached by practitioners and researchers. The critique is characterized by two fundamental inter-related arguments. The first one focuses on the normative dimension and pluralistic nature. Another one defines teamwork to be examined on conflict and differences and struggles between the competing sets of interest occasioned within the group or organization.
Within the operating theatre context, teamwork is a discursive means through which professional members negotiate the contradicting between integration and specialization. Teamwork is viewed as a divisive factor as it engages people from different professions (Freidson, 1988, p. 206). This creates conflicts as each of them contributes different opinions towards the best approach. This can constitute a poor organizational culture where there is a breakdown of communication. Improved health care has been on the forefront after recent studies showed that some death has occurred as a result of negligence and if care has been given such deaths would have been avoided.
The health care commission which reviewed complaints against trust said that of its 2007-2008, the result showed that some trusts were not responding to complaints effectively or learning lessons. The review also noted that the total number of complaints half of which were referred back to the trust for further work did not meet the initial response. The NHS which focused on England recommended improvement on how to deal with Medicare issues.
According to the data collected, it shows that one in every five complaints was about treatment or wrong diagnosis. This has gone on record in claiming a life of a patient who was wrongly fed with an epidural drug in the case cited. “A new mother was unlawfully killed when an epidural drug was mistakenly fed into her arm via an intravenous drip” (Evans, 2008) this could have been avoided if utmost care was observed. The other complaints involved delayed or wrong diagnosis, access of treatment, staff attitudes, communication, and information, substantial of patient or family member were not happy with the treatment administered and another number alleged that there was a wrong or delayed diagnosis. The overall results and recommendation tabled by the NHS commission show that the UK health care has a great task to undertake if they are to achieve the milestone in providing for better health care and improved customer care.
Although some categories of people criticize teamwork, it should be embraced to curb immature death some of which are as a result of lack of communication or interaction (Dussault, 2008, p. 209). Teamwork can serve ideological purposes in which language practices can play a central role in the mobilization, legitimization, and reproduction of interest in social structures. Teamwork can particularly serve in persuasive and rhetorical functions through which the desired cooperative spirit of teamwork can be achieved. There are also suggestions by Mueller (1994) that managerial control through teamwork is a contested process but it offers a degree of success.
The injection of professionalism in organizational learning leads to the establishment of group norms of conduct that govern the medical officers from engaging in malpractices. This is especially important in health care as it helps to bar the services of an unqualified medical practitioner, who is engaged with substandard medication. There has been an effort by the UK government to improve medical care; this includes making reforms on the health facilities. However the biggest task remains on the health care organization, this organization must change from the culture of individualism and adopt an encompassing culture of collectiveness.
Integration of all departments within an organization is a great stride as there is a great mapping of health problems from a different medical practitioner (Argyris, 2001). This leads to the practitioner adopting the best method of tackling the problem, which generally gives out the desired results. High regard should be given to health care has become one of the major contributors to the national economy. It is believed to be generating an average of 9% of the GDP. This is a significant amount and proves how much attention health care demands if the UK government has to continue enjoying the double digits economic growth.
Health care has adopted knowledge management in its effort to improve health care. In health care, the discourse of knowledge management is bounded by a range of interrelated terms often used interchangeably. Building knowledge management can help attain the organization’s goal as all their data are kept in one database. The management of past and present knowledge is an important aspect of organizational learning. How the data is managed in a Health care organization is determined by definition, built it generally cover all the instruction-based bit of organization.
Thereby, the profession of a medical staff member should be a method to provide the clients with required services at a high level considering the ethical and professional standards. In this respect, organizational learning should be implemented into health care requiring the medical staff members to acquire new knowledge and skills relevant for modernized mechanisms and devices that are aimed at improving the delivery of health care.
Theory on Professions
Occupations and professions
Some occupations are called professions because of certain characteristics differentiating them from ordinary occupations. Historically, different occupations were called professions, and the knowledge for these occupations was acquired in the medieval universities including the study of law, medicine, university teaching, and other activities that were independent of the category of customers; these occupations are called ‘professions’ because of their self-supporting nature which presupposes self-employment (Friedson, 2001). Professions should be defined as well as professions to make the difference obvious and emphasize the necessity of organizational learning relevant to the improvement of professional skills and knowledge. Glenn (2003) presents a good explanation of profession with the help of six elements of a profession defined by Allan Millet:
…a full-time and stable job, serving continuing societal needs;…is regarded as a lifelong calling by the practitioners, who identify themselves personally with their job subculture;…is organized to control performance standards and recruitment;…requires formal, theoretical education;…has a service orientation in which loyalty to standards of competence and loyalty to clients’ needs are paramount;…is granted a great deal of collective autonomy by the society it serves, presumably because the practitioners have proven their high ethical standards and trustworthiness” (pp. 26-27)
Differences between the concepts
Thus, self-regulation is one of the basic differences which is observed between the concept of occupation and the one of a profession. The representatives of the professions can demonstrate self-regulation, their labor is not bound to the need of gaining money, it hence is directed on developing knowledge and experience (in this case the patients appear as the means to explore the peculiarities of the human organism). The issue of gender facilitates the differentiation between the occupations and professions as traditionally the professions were the matter of males only. The hierarchy of the health care organisations is established in accordance with gender diversity including males on the top and females at the bottom of the job ladder.
The Concept of Organisational Learning
Organisational learning is deemed as the collective learning of the individuals in the organization. This knowledge is transferred overage and it encompasses the organizational culture. The NHS recently has emphasized the codification of individual and collective knowledge. In organizational learning, there are different kinds of learning. Learning about things involves the knowledge, communication, and analysis of the situation. Tactic knowledge arises from the skills of people, especially experienced people. Cultural knowledge is relevant to the customs, values, and relationships with clients and other stakeholders. Organisational learning is a method to implement innovations into the sector of health care. Health care provision is one of the most important responsibilities of any society.
There has been an increased call from the policymakers, medical practitioners, and academicians for the NHS and the private sector to adopt robust organizational learning to improve efficiency in the health care sectors. Learning has been identified as a central concern for a modernized NHS. The system encourages the continuity of individual professionalism in improving learning. Organisational learning is defined as the way the organization builds and organizes knowledge and routines and the professionalism of the workforce to improve organizational performance.
Although medical education emphasizes the importance of lifelong learning by an individual it should be noted that if the knowledge is left at the tactical level, major issues will be overlooked. To gain the overall benefits of learning across the organization, such learning should be deployed and shared with others within the organization (Halliday, 1985, p. 427). Learning is something that is undertaken and developed by an individual. It helps to improve competitiveness and better discharge of duty. However, an organization can foster or inhibit the process. Organisational culture and structures shape the way in which individuals are engaged with the learning process.
There have been different approaches to the management of knowledge. A codification and the personalization approach. The codification is computer-oriented. The knowledge in this case is stored in an electronic database and retrieved when required. The information contained therein is limited to authorized users only. In the personalized approach, the knowledge is embodied by the person who develops it. This form of knowledge can only be communicated to the rest of the organization during forums or during discharge of duty. The recent emphasis in the NHS concerns the codification of knowledge. This is important as it creates a source of reference where practitioners and patients can check for authentication of the products, notably medication. The personalization approach is most popular in cases involving interns or apprenticeship, where the knowledge is induced to the trainees as they get technical training. However, whichever node is adopted depends squarely on some other factors. These factors include a criterion of whether there is the provision of standardized services and products. Where the services and the product are standardized codification approach is adopted. In case the products are tailored to fit the tastes of individuals, the personalized approach is the best.
Creating a database with the information required helps improve the delivery of health care, where they can also call for referrals on past medication and history of diseases (Abbott, 1988, p. 46). Having this bank of information is only part of the challenge. The organization has to devise the best way to use that knowledge. The deployment of organizational knowledge in pursuit of organizational goals is called the learning routines and constitutes the learning organization. Healthy care should therefore identify, understand and improve the learning routines.
The learning routines used by the organization are classified according to whether they are adaptive or generative. Adaptive learning allows the organization to use some pre-defined pathways. The generative method involves developing a mechanism to help the organization achieve its goals. Both modes of learning are important to the organization but the most common routines found in an organization are those of adaptive learning.
Adaptive (single-loop) learning. This mode of learning has adopted the computer approach whereby the system is cybernetic. This means that the system can monitor itself to detect whether it is working towards the desired route. The negative feedback enables the system to loop to correct the error or give an error message. This is referred to as single-loop learning. A good example is a clinical audit in health care (Nutley & Davies, 2001, pp. 37-38).
Generative (double-loop) learning. Adaptive learning is necessitated by the fact that it is guided by the operating norms to result in a self-regulating system. However, this is only possible where the action is predefined and does not change over the learning cycle. If these actions are tampered with the system malfunctions, to counter this problem it has given the rise to a double-looped learning system. A Double-looped learning system leads to a redefinition of the organization’s goals, norms, and procedures. This is referred to as generative learning as it calls into question the very nature of the course plotted and the feedback loops used to maintain that course (Nutley & Davies, 2001, pp. 37-38). Building a learning organization has been deemed as developing an organizational culture (Senge, 1990, p. 259). This is because an incident happening in one department cannot be assumed to have been a lesson to other departments unless there is the integration of such departments into one discrete system.
Thus, single-loop learning is aimed at indicating the errors, gaps, and lack of correspondence. Detecting inappropriate implementation of the wee-organized standards is the issue appealing to the single-loop learning, whereas the reorganization of the health care system which has appeared to contain some gaps and errors in the issue appealed to double-loop learning. Consequently, the main difference is the response to the errors: the single-loop learning indicated those and the double-loop learning focuses on fixing the system in order to follow the commonly-established standards of the health care institutions.
Theory on Profession with Regard to Organisational Learning
Values facilitating organizational learning. Some techniques can improve the results of organizational learning. Celebration of success promotes and encourages the pursuit of excellence. The absence of complacency encourages constant research to find new and better ways of delivering products and services. Tolerance of mistakes advocates minimizing the possibility of occurrence of failures during discharge of duty. However, since this is almost inevitable it is required that any failure be addressed as a lesson to prevent future recurrence. Belief in human potential can be developed through the organization assessing and fostering human effort as they are the main contributors to knowledge skills and innovations. The culture within the organization should try to maintain the labor force for its continuity. Research and development budgets and programs about learning organizations assessing and investing in research as this give them a better position than other organizations. Prioritizing the immeasurable advocate on the judgments based on the qualitative understanding rather than the tyranny of numbers. Openness is revealed through the sharing of knowledge throughout the organization which is crucial in developing learning capacity.
The necessity of organizational learning. There is a great need for organizational learning, especially in the public sector. Like Ferlie et al. (2003) note, “the scale of public sector organization is of sufficient significance to warrant attention from organizational learning and knowledge” though the public has undergone substantial reform there is a need for the organization to develop organizational learning (Halliday, 1985, p.427). Another reason for encouraging organizational learning is because the literature on organizational learning makes references possible. Also, attention to issues affecting learning and knowledge in the public organization may help expand knowledge about the field across all types of organizations.
Conclusion
Due to the sensitivity of health care and its position in society, the organization must adopt more customer-friendly approaches to fully address health issues in the UK. This will contribute towards the firm attaining a positive public image. The major initiative adopted by the public health organization should be backed by the government to ensure they are brought to fruition. Individual learning in improving competency should be encouraged from the individual level and organization level. The individual level involves individuals pursuing more education to improve on their know-how and help them become more competent in discharging their duties in areas of their profession.
The organizational level of education involves the formation of teamwork, where knowledge is disseminated across the organization. This has the significance of involving every member of the organization. The resulting trend of interaction creates a culture of collectiveness (Bolton, 2005, p. 17). Use of the Knowledge management in health care has received much applaud and it has generally improved on both data mining and storage of data in an electronic form. Also, medical practitioners are using the capabilities of those knowledge systems to come up with a sophisticated mode of medication. The government has also documented a health reform in England. It focuses upon developing a first-rate commission to create an NHS where patients have more choice as well as a real voice in the design of their services. This is a result of the outcome of the results that showed that the Health care was contributing to an upward of 9% in the GDP of UK.
Health organizations should also deploy more elaborate measures to deal with the case of professional negligence. Most of these cases should either be dealt with through the establishment of a medical (professional) body to oversee, enact and effect laws governing how medical discipline should be conducted. The other measure may include the government forcing individuals to pay for their negligence where the death of a patient results from negligence. Health care should also embark on developing a powerful system to collect the views of the customers concerning the medication and services they receive. This feedback will help the organization identify the underperforming department and take the correct measure. This also improves customer relationships with the health organization and carries the conviction that they receive the right treatment.
Appreciation of teamwork in an organization supported by knowledge management can help health care achieve great strides in ensuring a healthy nation. Knowledge management can be attained through the creation of a knowledge repository within organizations. This means that individuals involved in delivering healthcare services will be more skilled. On the other hand, organizational learning will also be vital in ensuring the customer gets the best medical care at a better price. The government and the health care organization should embark on funding researches as this is the only way to find innovation.
References
Abbott, A., 1988, The System of Professions. Chicago: University of Chicago Press.
Argyris, C., 1991. Teaching smart people how to learn. Harvard Business Review May-June, pp. 99-101.
Bolton, S., 2005. Making up’ managers: the case of NHS nurses. Work, Employment And Society, 19 (1), pp. 5-23.
Bolton, S. & Muzio, G.D., 2007. Can’t live with ‘em; can’t live without ‘em: gendered segmentation in the legal profession. Sociology, 41 (1), pp. 47-64.
Dussault, G., 2008. The health professions and the performance of future health systems in low-income countries: Support or obstacle? Social Science & Medicine, 66, pp. 2088-2095.
Evans, S., 2008. New mother ‘unlawfully killed’ by blunder. The Independent, 5 February.
Freidson, E., 2007, Professional Dominance. 2nd ed. New York: Transaction Publishers.
Freidson, E., 1988. Professional Powers A Study of the Institutionalization of Formal. Chicago: University of Chicago Press.
Freidson, E., 2001. Professionalism, the Third Logic on the Practice of Knowledge. Chicago: University of Chicago Press.
Glenn, R. W., 2003. Training the 21st century police officer: redefining police professionalism for the Los Angeles Police Department. Santa Monica, California: Rand Corporation.
Halliday, T., 1985. Knowledge mandates: collective influence by scientific, normative and syncretic professions. The British Journal of Sociology, 36 (3), pp. 421-447.
Nutley, S. M. & Davies, H. T. O., 2001. Developing organisational learning in the NHS. Medical Education, 35, pp. 35-42.
Senge, P.M., 1990. The fifth discipline: the art and practice of the learning knowledge. Chicago: University of Chicago Press.
Nursing is a very challenging profession with a lot of difficulties and other issues. It should be mentioned that when people choose the profession of a nurse they orient to some particular vision of this occupation. However, when the people’s expectations are not met and nurses face many difficulties they become frustrated. Thus, the lack of inspiration motivation and professional challenges play a great role in the nurses’ desire to leave their profession. The purpose of this paper is to dwell upon the main reasons why nurses leave their profession and to comment on them. Focusing on the results which MacKusick and Minick provide in their research “Why Are Nurses Leaving? Findings from an Initial Qualitative Study on Nursing Attrition”, it is possible to note that the main problems nurses can face are the unfriendly workplace, emotional distress related to patient care, fatigue, and exhaustion. Each of these points will be highlighted in the further section.
The Role of the Unfriendly Workplace Environments
As it was mentioned above, many nurses are inclined to leave their profession because of such reasons as the unfriendly workplace, emotional distress related to patient care, fatigue, and exhaustion. Speaking about the unfriendly workplace, it is necessary to exclude the issues connected with the nurse-patient interactions. The problem of relationships among employees is discussed. This issue is rather urgent concerning young and inexperienced nurses. According to MacKusick and Minick’s findings, nurses pay attention to such aspects associated with the unfriendly workplace as the “sexual harassment”, “verbal or physical abuse from co-workers, managers, or physicians in the workplace”, and/or “consistent lack of support from other RNs” (MacKusick & Minick, 2010, p. 337). Nurses often suffer from the constant pressure at the workplace, and this fact decreases their performance. Brown concentrates on definite examples of the unfriendly workplace environments which are based on the abusive treatment of new nurses, lies about the work which is done and not done, refusal in helping, the public correction of some nurses’ mistakes, and other similar issues (Brown, 2010).
The Problem of the Emotional Distress
The emotional distress related to patient care is the second reason why nurses leave their profession. Nurses are inclined to think that the patient’s and relatives’ desires and interests are often not met, and their task is to provide high-quality care. Nurses discuss such problems which cause additional emotional tension as the “overly aggressive treatment, lack of collaboration between physicians and staff, and lack of respect for patient and family wishes caused recurrent emotional distress” (MacKusick & Minick, 2010, p. 337). All these factors affect the nurses’ desire to leave.
Nurses’ Fatigue and Exhaustion
Finally, fatigue and exhaustion can also become the reason for leaving. Nurses are to be available for 24 hours and 7 days. Nurses’ schedules are often too strict (Brown, 2010). Nurses have an opportunity to spend free time with their family and friends, but they should be available in case of emergent situations. It is especially discouraging when a nurse comes home after the 24-hour working shift, and some emergency makes him or her go to work again.
Conclusion
Therefore, emotional pressure is one of the main reasons why nurses leave their profession. Being exhausted emotionally and physically, many nurses are unable to bear stressful situations, and they leave their profession. Nevertheless, the profession of a nurse has many advantages, but many problems at the very beginning of the career can discourage young nurses concerning further professional development.
References
Brown, T. (2010). When the nurse is a bully. Web.
MacKusick, C. I., & Minick, P. (2010). Why are nurses leaving? Findings from an initial qualitative study on nursing attrition. MEDSURG Nursing, 19(6), 335-340.