NUR4169 Nursing Research And Evidence-Based Practice

1. Describe how the role of advanced registered nurse transformed over time. Consider shifts in scope and expectations in the 20th and 21st centuries. In what ways will the advanced registered nurse role and responsibilities continue to evolve and emerge as the American health care system changes?

 

2. Professionalism consists of certain attitudes, beliefs, and behaviors. We cannot see into the minds and hearts of others to gage their professionalism.  Fair or not, character judgments are made from outward signs such as what people say and do. Consider the readings, especially some of the stories and case studies. How does nursing as a profession differ from other work groups? Is there a different standard of professionalism for an advanced practice nurse than for an RN or LPN?

 

3. Access The Future of Nursing: Leading Change, Advancing Health. Identify the two recommendations for nursing education you believe will be most effective or radical in creating change within the industry. Provide rationale based on your experience in practice. Do you agree or disagree with how the Institute of Medicine (IOM) describes the advanced practice registered nurse role evolving? Why or why not?

1. A transformed healthcare system will require redesigning the role and responsibilities of healthcare professional and nurses, to deliver effective care and treatment to patients. Nursing represents as the largest sector of the health professions with more than 3 million registered nurses in United States. The new healthcare law identifies challenges in the management of chronic conditions, primary care, prevention and patient’s wellness, and prevention from clinical misadventures or adverse events. Thus, it shows a radical change in the scope and expectations in the nursing practices from 20^th to 21^st century. Population’s healthcare needs have changed; there has been more scope towards training or educating nurses to ensure undertaking complex roles to deliver effective services to patients  (Salmond  & Echevarria, 2017). Today nurse practitioners, (NPs) together with healthcare professionals are more committed towards their responsibilities in providing their most of the primary care in the United States (Smolowitz et al., 2015).

In addition,  the number of NPs and other physical assistants in the healthcare are steadily increasing while, the medical residents and the residents going to primary care has been decreased. Roles and responsibilities of the nurses in the American healthcare system has been evolved over time, as they are now focused and driven towards delivery valuable services towards their patients. Role of the registered (RN), leading healthcare states that nurses have now operate as full partner to achieve the triple aim of an improved patient in American healthcare. These aims include assuring quality and satisfaction of the services, improved outcomes, or health of the population, and decrement in the per capita cost of these health-cares. Hence, these are the ways mentioned above stating about evolution in the advanced registered nurse roles and responsibilities (Hoeve, Jansen & Roodbol, 2014).

2. Professionalism in any field requires obligations, duties, and responsibilities to be fulfilled by an individual, complying with standard behaviour or attitude towards work. Professions refer to those occupations, a mix of qualities and thought be a skill, self-sufficiency, duties, or obligations. Nursing is considered a free and helping profession that provides benefits and adds strength to the individual. Crucial components of the nursing practices include care, cure of the patients and co-appointment.  Professionalism and the code of conduct followed in the nursing differ from other profession or work groups such as teachers, or any social worker (Stewart et al., 2015). For an instance, to compare the nursing profession with a teaching or teacher, both focus on helping others providing care in different ways. Similarity is that both then jobs require licensing, and offer advancement opportunities but they differ in their working. In cases of law enforcement, and nursing both of their goals is to help others, social workers helps people through varied life challenges whereas, in nursing an individual is primarily involved in the health outcomes of patients. Similarly, nursing practice or profession differs in some way or other from other professions and working. Case study related to nursing, i.e. nursing practice councils: The Quest for excellence states that the quest to achieve excellence in nursing requires nurses’ enthusiasm, commitment, dedication and a positive approach in the healthcare (Coyne et al., 2016).

They need to be strong, follow morals and ethics of professionals, to act for benefits of the patients. Others include treating all patients equally, behaving in responsible and professional manner and positive attitude towards work is essential.  In cases of adverse events in treating patients, they must listen to the parents of the patients, and must not enforce their standards or decision upon patients or their supporting members. Professionalism standards for an advanced nurse than an RN or LPN states that RNs have more duties than a LPN and they are frequently added more in the hospitals. The duties for LPNs are more limited whereas, RNs are accountable and responsible, and are expected to have active license more than LPNs (Manners, 2017).

3. Discussing about the future of nursing, leading changes and advancing health, it has been analysed that United States have the opportunity to transform their healthcare system to provide effective and quality healthcare services. Future of nursing deals with exploring the roles and responsibilities of the nurses to be changed to meet the increased demands of the quality care in the healthcare.  Thus, it will be ensured by the healthcare, to make reform or changes in the increasing complexity of the American healthcare system. To achieve this transformation in the healthcare, it will require remodelling or reshaping the aspects of the healthcare system in the United States (Masters, 2015). 

There are some recommendations, which can help in delivery effective healthcare services to the patients. Recommendations in nursing education describe that nurses should be prepared to meet the diverse needs of the patients, function as leaders, and advance science and benefits to the patients. Data collection must be improved for workforce planning and policy-making. At the same time, nursing education must be directed towards making nursing graduates to work collaboratively and co-operatively with other health professionals in the evolving system in United States (DeNisco & Barker, 2016). In the year 2010, the Institute of Medicine (IOM) has released the report Future of Nursing; report contains information about leading change and advancing health, which made a number of suggestions related to the roles of the nurses in the new era of healthcare system. The report was to provide an in-depth look at the roles of the nurse in evolving era. Yes, I agree with the way Institute of Medicine (IOM), described and recommended about the advanced practice registered nurse’s role has been evolving. IOM states that there are barriers that prevent nurses from becoming effective in responding to the increasing changes in the healthcare system (Porter-O Grady & Malloch, 2015). The rationale of choosing those recommendations is to ensure elimination of the barriers in nursing practice so that nurses can effectively deliver their roles, with their full potential. Eliminating barriers will help them towards focusing on the changes, so that they are in a position to lead change and advance health. Therefore, IOM stated that barriers such as regulations in their roles and practices, and turnover rates, which should be eradicated to improve the healthcare; opportunities for nurses must be created so that they can explore their role and responsibilities and become effective (Pittman et al., 2015).

References:

Coyne, I., Comiskey, C. M., Lalor, J. G., Higgins, A., Elliott, N.  & Begley, C. (2016). An exploration of clinical practice in sites with and without clinical nurse or midwife specialists or advanced nurse practitioners, in Ireland. BMC health services research, 16(1), 151.

DeNisco, S. M.  & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession. 3^rd ed. Burlington: Jones & Bartlett Learning.

Hoeve, Y. T., Jansen, G. & Roodbol, P. (2014). The nursing profession: public image, self?concept, and professional identity. A discussion paper. Journal of Advanced Nursing, 70(2), 295-309.

Manners, R. A. (2017). Professional dominance: The social structure of medical care. United Kingdom: Routledge.

Masters, K. (2015). Role development in professional nursing practice. United States: Jones & Bartlett Publishers.

Pittman, P., Bass, E., Hargraves, J., Herrera, C., & Thompson, P. (2015). The future of nursing: monitoring the progress of recommended change in hospitals, nurse-led clinics, and home health and hospice agencies. Journal of Nursing Administration, 45(2), 93-99.

Porter-O Grady, T. & Malloch, K.  (2015). Leadership in nursing practice: Changing the landscape of health care. 2^nd  ed.  Burlington: Bartlett Learning.

Salmond, S. W., & Echevarria, M.  (2017). Healthcare transformation and changing roles for nursing. Orthopaedic nursing, 36(1), 12.

Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.  (2015). Role of the registered nurse in primary health care: meeting health care needs in the 21st century. Nursing Outlook, 63(2), 130-136.

Stewart, K. R., Stewart, G. L., Lampman, M. M., Wakefield, B., Rosenthal, G., & Solimeo, S. L. (2015). Implications of the patient centred medical home for nursing practice. The Journal of nursing administration, 45(11), 569.