Healthcare Climate: Nursing Profession Research Paper

Introduction

• Nursing history is as old as humanity
• 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 Nursing which is traditionally known as being a caring profession is also changing and has been replaced by a computerized system (Watson, 2002).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:

1. The content of nursing education must be defined by nurses.
2. Nurse educators are responsible for the nursing care provided by students and graduates of the nursing program.
3. Educators should be trained nurses themselves.
4. Nursing schools should be separate entities, not connected with physicians or hospitals.
5. Nurses should be prepared with advanced education and should engage in continuing education throughout their careers.
6. Nursing involves both sick nursing and healthy nursing and includes the environment as well as the patient (holism).
7. 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.

NCSBN, (1986) Advanced Clinical Nursing Practice. [Online], Nursing Position Paper. Web.

Wikipedia, (2009). Nursing. [Online], Wikimedia Foundation, Inc. Web.

Rogers, A.E. et al., (2004) The Working Hours of Hospital Staff Nurses And Patient Safety, Health Affairs, Vol 23, No 4, pp 202-212.

Watson, J. (2002). Assessing and measuring caring in nursing and health science. New York: Springer Publishing Company.