The role of RN in primary, secondary, and tertiary healthcare settings can be broadly defined as providing the patient with means for addressing the patient’s needs associated with a health issue. The said means are collectively known as self-care and dependent-care agencies (Orem, 2001). It is important to understand that these agencies are available to each individual but may not be sufficient for addressing a specific dependent-care demand. Therefore, the individual would require the assistance of an external agent (e.g., the nurse) who would provide a necessary amount of agency to eliminate the emerging deficit.
It is thus possible to say that identification of the deficit areas is among the priorities of RN in a primary and secondary healthcare setting. Once the needs are identified, the nurse’s role shifts to monitoring the state of the patient and adjusting the amount of dependent-care or self-care agency. For primary care, it is reasonable to assert the high degree of dependency since the hospital setting is showing a tendency of the shift towards accepting the most acutely ill individuals. However, every time a change in need is identified, the RN is expected to adjust the level of healthcare to ensure the best patient outcome along with the optimal use of resources.
Factors Influencing Patient Outcomes
The said roles are largely determined by the factors that influence patient outcomes. These factors include the environment, spiritual and cultural values, social roles, and developmental processes. The environmental factors include the familiarity with the hospital setting, which is expected to improve the efficiency of treatment and equipment interaction, although, in the case of previous negative experience, the opposite effect may be observed due to anxiety. In addition, the environment may pose threats to the patient’s health (e.g., hospital-acquired infections). Therefore, nurses’ roles include timely identification and prevention of potential issues.
Another factor is the risk of spiritual distress resulting from stressful treatment processes and outcomes and leading to emotional disturbances. Besides, the cooperation and involvement of the patient may depend on certain spiritual concepts and/or religious beliefs. According to Gorin and Arnold (1998), a positive relationship can be traced between the strength of spiritual commitment and the ability to cope with challenging situations. It is also worth mentioning that the connection between spiritual practices and healthcare is traceable in many cultures throughout history (Hart, 2008). Finally, spirituality shows the capacity for improvement of patient outcomes through interaction between patients, their families, and healthcare providers (Torosian and Verschka, 2005). Thus, the available information and likely effects of the described factors must be incorporated into the plan of care.
Similarly, the cultural background shapes the behavior of the patient and must be acknowledged in the process of care planning. The most common framework used for the purpose involves communication, time orientation, spatial orientation, social organization, environmental control, and biological variation considerations (Giger & Davidhizar, 2002). It is reasonable to expect breaches of cultural concepts and norms by the nurses. Therefore the adoption of the said model gives nurses an opportunity to decrease the likelihood of undesirable effects.
In some cases, the health condition may compromise the normal development of a patient, creating uncertainty and leading to stress. To prevent this, RN must prevent unfounded concerns and minimize the adverse effects associated with justified ones.
Finally, treatment and its after-effects often have a significant impact on patient’s social interactions. Simultaneously, the family members experience stress, further compromising social support and, by extension, undermining the decision-making process and patient involvement (Appleyard, Gavaghan, Gonzalez, Ananian, & Tyrell, 2000). Thus, RNs must ensure maximal social support for patients and monitor their social interactions to minimize stress and increase patient satisfaction.
By acknowledging the described outcomes and incorporating them into the care delivery process, it is possible for RNs to eliminate unpredictable factors and increase the long-term efficiency of healthcare through improved patient outcomes.
References
Appleyard, M. E., Gavaghan, S. R., Gonzalez, C., Ananian, L., & Tyrell, R. (2000). Nurse-coached intervention for the families of patients in critical care units. Critical Care Nurse, 20(3), 40-48.
Giger, J. N., & Davidhizar, R. (2002). The Giger and Davidhizar transcultural assessment model. Journal of Transcultural Nursing, 13(3), 185-188.
Gorin, S. S., & Arnold, J. H. (1998). Health promotion handbook. St Louis, MO: Mosby.
Hart, J. (2008). Spirituality and healing. Web.
Orem, D. E. (2001). Nursing concepts of practice (6th ed.). St Louis, MO: Mosby.
Torosian, M. H., & Vershcka, R. B. (2005). Spirituality and healing. Seminars in Oncology, 32(2), 232-236.