Nursing theories inspiring my nursing practice

Swanson's Theory of Caring is one of the most influential philosophies influencing nursing practice. The philosophy focuses on healing and teaching during pregnancy and miscarriage in particular. The patient's healthcare providers and families must help the patient go through the miscarriage recovery process in order to bring closure. The theory says that there are five categories or procedures that nurses should follow in order to increase the patient's well-being (Watson, 2008). Knowing, being with the patient, doing for, enabling, and keeping the brief are all procedures. Swanson's notion is critical for providing patients and their families with adaptive methods. Similarly, the theory teaches the caregivers on ways to physically and emotionally family members back to fitness and well-being.

As a nurse, I encounter women who have experienced stillbirths and miscarriages. The fetal demise is very traumatizing to the women, the family members and the caregivers. The Swanson’s theory is important to the nursing as it encourages patient-nurse relationships. The nurse talks to the patients and the family members to know their feelings. As a nurse, I enable the patient through encouragement and optimism. Maintaining brief with the patients is critical too, and the nursing profession help is eliminating any uncertainty in regards to patients future. The patients heal and forget the past and are ready to face the future with confidence (Swanson, Chen, Graham, Wojnar & Petras, 2009).

B. Historical Nursing Figures

Florence Nightingale in the 19th century had a significant contribution to the nursing profession and practice. The philanthropist from the upper-class of English society involved herself with caring for the sick. She had the calling to care for humanity. She took part in the Crimean War in 1854 where so many soldiers were wounded. Mortality of the British troops was at 41% due to lack of nurses among the troops. Many soldiers died from diseases instead of injuries picked on the battlefield. She advocated for the cleaning of the hospital wards in the barracks to remove dirt and pathogens. The number of deaths decreased within months. Her knowledge in statistics helped in the maintenance of healthcare and sought further intervention for the soldiers. She laid down the evidenced-based practices that are the daily routine in the healthcare to date.

Jean Watson came up with the nursing theories that involve the patients’ spirit, body, and mind during care delivery. Her work examined the dynamics between the patient and the healthcare providers. The dynamics of the two human beings interactions affects how the patients perceive the current health status. Watson developed several factors that have a direct contribution to any clinical setting to fully meet the physical, emotional and spiritual needs of patients (Caruso, Cisar & Pipe, 2008).

Many nurses in the past were preoccupied with scientific and tangible aspects of disease curing. Coming into the 21st century, the roles of the nurses have changed. The nurses should have the competencies to take into consideration the spirit, body, and mind of the patients. The role of the nurse is not to cure the diseases of the patient. Rather, the nurse should honor the dimension of human caring in nursing. As a nurse, I work on the inner life by feeling the patient need in the world thus serve using subjective experiences.

C. State Board of Nursing and the American Nurses Association (ANA).

The State Board of Nursing promotes and protects public welfare by ensuring that the medical practitioner holds the correct license and certificates for safety and competence in care delivery. The American Nurses Association (ANA) is an organization made of nursing professionals that aim at protecting the nursing practice. The organization protects, promotes, and optimizes health and capabilities, injury and illness protection, suffering alleviation and responding to human concerns. As a nurse professional, I can advocate individual patient care, family, community involvement in the delivery of care services. Therefore, the provision of service equitably gets to all who seek medical attention.

Lack of nursing Licenses Implications

The state discipline nurses if proven allegations that one does not have proper documentation in nursing practice. In my state, the regulatory body censure and reprimand the nurses violating nursing licensure rules. Also, offender nurses face on probation of a specified period allowing the board to monitor the job performance of the nurse.

Compact State Versus a Non-compact State

The Compact states allow nurses in possession of compact license mobility to work across state lines from other compact states with electronically, physically or telephonically compact state boards. The state allows the registered nurse to hold multiple licenses (Mikos, 2013). The public enjoys better healthcare services due to the new levels of cooperation between the nurses. The non-compact states such as California, however, feel that the NLC will weaken public safety due to decreased ability of the state to regulate nursing practice. These States notes that the compact will dilute state laws and will constantly have to educate their LPNS and nurses.

D. Nurse Practice Act

The states have passed as the Nurse Practice Act. The NPA, however, is insufficient to provide necessary guidance for the nursing profession thus has the board of nursing that is the authority responsible for administrative of regulations and rules. The NPA is the body that mandates the Board that regulates responsibilities and Practice for the registered nurse. The NPA implementation appears in Californian Code of Regulation and is under California Business and professional code. California Board of Nursing and Board of Vocational Nursing and Psychiatric Technicians are the separate nursing practice licensing agencies. California is a non-compact Nursing Licensure State. All the LVS and RNs nurse must take the NCEX exams. Qualified personnel from other jurisdiction may be eligible for licensure by endorsements as due to the non-compact listing of California.

In Missouri, the Nursing Board comprise of nine members appointed by the governor and are responsible for making sure that the LPNs and RN comply with chapter 335 of the Nurse Practice Act. In addition, the board plan, make policies and has the mandate to ensure effective application of the law. The RN, LPN/LVN must pass the NCLEX examination before acquiring licenses. Nurses from other states too must go through similar evaluation processes. The nurses have a two-year renewable license (LPNs renew in even year and RN in odd years).

The rules for safe practice in California and Missouri have similar laws that protect the practicing nurse and those who need care. They regulations have safety parameters and guide nurses in their work as well as protecting patients from unsafe nursing and unethical practice. The functionality of the nursing professional depends on how the nurses understand the rules and regulations in their states.

E. Provisions from the American Nurses Association (ANA) Code of Ethics

Provision 1

The nurses need to have the professional relationship in their practice. The nurses need to have respect and compassionate for the inherent worth, dignity, and uniqueness of the patients seeking medical care. I have the respect for human dignity in my work. I neither ignore nor segregate the patients due to race or economic background. I try to maintain good relationships with the patients transcending into individual differences without prejudice. I use the values system, lifestyle, religious belief in planning for the healthcare service to my clients. However, I not necessarily have to condone or agree with certain choices but respects the patients as human beings.

Provision 2

The nurses must promote, advocate and strive to protect the safety, health and patients’ rights. The patients have the right to privacy. The healthcare delivery provisions do not allow unjustified intrusion into the life of the patients. The nurse advocates environments that promote enough auditory and physical privacy. Confidentiality relates to privacy, and it is the duty of the nurse to keep all patients’ information confidential. The right, safety and the well-being of every patient should be the fundamental factors driving professional judgment through confidential information retrieved from the patient whether oral, written or electronic. Illegal and unethical practice by any health team member is detrimental to the rights and best interests of the patients.

Nursing Error

According to Barach & Small, (2000) to err is human. I once failed to dispose-off some documents that contained private information of a patient. My manager was walking around the health center and spotted a trash bag accidentally opened or tripped open. There was patient some papers containing my patients’ information. I discarded the information with the best intention but never predicted that it would resurface in such a trash bag. When no longer needed, I should have disposed of the confidential papers by shredding. According to ANA codes of ethics, all essential information must remain confidential to secure the privacy of the patients.

F. advocacy of RN, LPN and nursing assistance

Registered Nurse

Registered Nurses advocates liaise between physicians and patients. They help patients gain an understanding of the medical condition thus assists them in making informed right decisions about their health (Mahlin, 2010). The nurse advocate finds alternative solution to treatment but avoids conflict with the doctors who give instructions on what exactly need to be done to the patient.

The Registered Nurses play an essential role in ensuring clinical research studies are carried out successfully, and participants are fully informed and safe. Clinical research is important in finding new treatment methods thus improved healthcare delivery. The nurses become advocates of the patients thus ensure safety, protection, and support throughout the research process.

The Registered Nurse must ensure positive attitude in the healing environment. The nurse managers understand the complexity of the environment and how to reduce anxiety among the staff and patients (Mahlin, 2010). The patient care unit must support the patient care and healing environment. Managers must take care of the workers that in turn take care of patients in a better way.

The LPNs are advocates to the patient and supplies information. Advocating involves supporting and standing up for the rights of patients when such patients cannot protect their personal rights. The LPN tries to improve the patients’ situation (Kerfoot & Neumann, 2002). As scientists, the LPN supports the nursing practice. The LPN can support research towards the identification of problems in patients. Identification of the problems calls for a solution, and the nurses must follow the evidenced based practice. Research help in identification of the standards of practice and best treatment options to the patients.

LPNs

In the clinical environment, the LPNs have a wide range of tasks offer considered as nurse care. The LPNs are the ears and eyes of the physicians and Registered Nurse, practically, the LPNs have straight and hands-on time with the patient compared to the doctors and RN. They are required to have an accurate assessment and diligent in serving patient. Additionally, the LPN assess, monitor patients, medicine administration and changing patient dressings. As healing environment managers, the LPN ensures that the planned care is followed to the latter (Kerfoot & Neumann, 2002). Many LPN is involved creating and evaluating the effectiveness of patient’s plans. The LPN manages the patients as well as co-workers in the delivery of care. LPN is mostly given the responsibility to supervise the assisting nurses in the organization.

Nursing assistant/unlicensed assistant personnel

Nursing assistance is at the bottom of the nursing organization hierarchy and works under the supervision of LPN or RN. The assistant nurses are an important part of the healthcare. They provide services such as feeding, dressing, bathing, transporting, obtaining temperature and pulse and making the report on patient progress. The nursing assistant leaders ensure that the staff prepare equipment, care for the patient, maintain good health in patients’ room and keep proper records.

G. Implications of FDA and CMS in Patients requesting Alternative Therapy

The Food and Drug Administration (FDA) engage manufacturers through evaluating and approving new medical products before releasing them in the market (Hill & Torres, 2012). Some patients experience effects of therapies and drugs prescribed due to the uniqueness of individuals. Every individual patient has a different perspective of the healthcare givers. However, the FDA engages the patients through patient networks. Consumers can search for information regarding their personal health, clinical trials and investigational products yet to release in the market. The FDA has patient representatives who have a unique perspective from those of the patients and their family member. Patients suffering from life-threatening illness may ask for a different treatment or therapy. The FDA Representative will be ready to offer advice on whether the medical products sought are beneficial or would put the patient at a higher risk.

The institute of medicine promotes healthy and safety in the working environment for the nurses. The practitioners must work to reduce errors thus reduce injury risk to the patients. The CMS has regional officers with the responsibility of implementing the CMS activities at the local level. The officers try to safeguard the health and well-being through trust funds. The CMS has ongoing patient advocacy, customer services and maintain professional relations to solve problems to all stakeholders. The Centers for Medicare and Medicaid Services penalize hospitals that fail to uphold preventable events and readmission, infections, patient falls and injuries to the patient. The financial penalties are based on staffing and care delivery outcomes.

H. Leadership Qualities

1. Collaborator, Communicator, Motivator and Accountable

The nursing profession produces leaders from boardrooms to bedside who can work towards collaboration, accountability and high-quality delivery of care. Leaders must have communication skills, visionary, credibility, accountability today and in future nursing practice. Leadership is required at every level across all settings. At the bedside, the nursing leader assigns the duties to the Registered Nurses and LVNs to oversee the completion of care and managing the safety of the patients. The leaders are accountable to the patient and the nurses. The leaders communicate and listen effectively to ensure proper consultation during care delivery. The leadership qualities and attitude are great contributors to quality health improvement at the bedside.

Team Leader

The team leader nurses provide instructions, guidance, leadership and direction to a group of nurses working together for a common goal. Mentoring team members with constant communication is vital increasing abilities to create ideas. The team leaders can motivate the team members. The team members will strive to be best healthcare providers due to job satisfaction. Recognition and ongoing rewards significantly motivate employees thus enhance creativity and innovation (Grossman & Valiga, 2017). The leaders need to have face-to-face meetings and offer words of praise and encouragement. The workers understand that the leaders have some interest in them. It is important to set objectives and goals for the staff and reward the best performing with fully-paid training, conferences or a day off for relaxation.

Leadership in Inter-disciplinary Departments

Leadership in the collaborative environment is crucial in diverse teams of professionals-nurses, physicians, consultants, and therapist. Collaborating teams work together to solve problems in the healthcare. The interdisciplinary team must communicate to have better service to the patient population. Senior leadership and physicians and the nurses must have rounding of all units daily. Each week the different departmental heads need to meet and discuss issues relating to the clinical environment. The leader provides an open line of communication and trust among team members. According to Grossman & Valiga (2017), communication among the team members allows for cooperation and coordination of activities. Poor communication causes increased risks of harm and fragmented relationships between the patients, nurses and the family members. Teamwork involves listening to each other thus determine the ideal course of action in care delivery. The lateral integration enables the clinical leaders to become an advocate for the patients or the stop-gap professional. Ultimately, the collaboration assists in minimizing lapses and fragmentation in patient safety and care.

2. Impact of Organizational Structure

The nursing organizational structure allows arrangement the clinical staffing according to their duties, responsibilities, and powers. The standards organization structures have senior managers, junior manager/ supervisors and manage floor-nurses. The senior executives or chief nursing officers (CNOs) are the overall heads in the organization (Comack, 2012). At our hospital, the CNO is part of hospital executive board that makes decisions involving operations. The CNO oversee budgeting, training, regulatory compliance and patient care delivery. The department managers oversee the clinical operation at the hospital. The activities include emergency, telemetry, obstetrics, surgery, critical care, cardiology, and orthopedics. The departmental heads execute departmental budgets, staffing requirements, clinical outcomes, collaborating with physicians and solving daily departmental issues.

The Nurse Managers operate under departmental managers. These managers oversee the floor nurses, plan shifts, and ensure adequate nursing supplies, collaborating with surgeons and physicians. They are in charge of the entire clinical setting care and report the same to department heads. The charge nurses supervise their department and nurses allocated shifts in the absence of nursing managers. The nurses are answerable to the charge nurse during weekends and solve matters regarding specific shifts. The charge nurses oversee emergency, and immediate execution of patients care issues. Lastly, the floor nurses have the duty to deliver patient care and form the bulk of the clinical nursing staff in our organization. Floor nurses follow orders from clinicians and assists patients to reach discharge. Additionally, they administrate medication, educate patients and engage the family members.

References

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