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TODAY AND BEYOND NURSING

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These are questions and answers relating to present and future nursing

Three challenges nurses face today in care delivery

  1. Bullying and harassment

Nurses experience a great deal of workplace bullying and harassment either by patients or by colleagues. Some patients bully/harass nurses by stalking, persistent and unnecessary communication overtures and inappropriate social media conduct with nurses (Stein & Deese, 2018). Nurses also get harassed/bullied by other nurses and other colleagues like doctors and physicians. Sometimes the harassment is sexual in nature.

To curb these incidents, nurses should first strike a balance between been too friendly and been too professional with patients. They should deliver their care duties with empathy and friendliness but be assertive and in control of the patient-nurse relationship (Cowen & Moorhead, 2018). Workplace measures to prevent harassment such as screening for firearms, lockdown procedures extra security in hospitals and others should be enhanced in hospitals.

  • Workplace hazards

In the course of discharging care duties to patients, nurses face several workplace hazards including exposure to bloodborne pathogens, workplace injuries, handwash based germs and others. As much as they try to take precautionary measures against these hazards, there is always a chance of getting exposed to them (O’Lynn & Tranbarger, 2018).

To reduce or eliminate instances of workplace hazards, hospitals should institute extra safety measures such as safe pass zones in areas with high chances of encountering such hazards like operating theatres where sharp objects and equipment are safeguarded (Huston, 2019). An increase in awareness on these hazards and injuries can also a long way into eliminating their occurrence.

  • Work-home balance

Due to shortage of nurses especially in public hospitals which lead to pro-longed working hours, nurses have a hard time striking a work-home balance. Extended shifts mean they have little time to spare for their private and family life (Stivers, 2018). This may lead to their private lives suffering at the expense of their careers.

To mitigate against this, nurses should try to infuse some aspects of their home life in their daily work routine. They can be instance go for workouts or visit their kids at school or go for dates during lunch breaks (Stivers, 2016). Hospitals should also strive to provide nurses with seasonal breaks (in the form accrued public holidays due) so that they can go and attend to family and private matters.  

  1. One of the messages of the Institute of Medicine 2010’s Future of Nursing committee’s report was that nurses should be fully recognized partners with other medical professionals such as physicians in redesigning health care

This means that in order to fully transform the health care system, there is need for nurses who have adaptive capacity to handle re-strategized and re-thought responsibilities in new settings. This calls for nurses to increase their skills and capacity to take on the re-conceptualized roles through re-education as they progress in their careers (Bonuel, Cesario, & Cabading, 2017). By becoming well informed, educated and skilled professionals, nurses in various positions of healthcare, whether its in hospital wards, in nursing schools as educators, in policy boards as policy shapers or in administrative roles will serve as full and equal partners in designing healthcare issues (Sherman, Schwarzkopf, & Kiger, 2019). As the ones at the forefront of direct patient-care, nurses are at a unique position to provide information (derived through work experiences) that other professionals may not be able to possess. This information can be used to re-design and re-strategize working healthcare policies (Skiba, Connors, & Jeffries, 2017).

 Nurses are tasked with providing hands on patient care through communicating with patients on health status, medications, treatment regimens and also in ensuring the regimen results in optimal outcomes. They should therefore take the responsibility of identifying issues in their areas of operation and devise and implement methods of improving/adjusting on the issues in order to realize established goals. Nurse should therefore view themselves as shapers of policy rather than only participating in implementation (Storch, Rodney, & Pauly, 2019). They should therefore be full actors in the arena of policy making, advisory boards, committees and commissions that come up with decisions, policies and strategies for healthcare implementation.

Importance of This Message on Healthcare

The idea of including nurses in every aspect of healthcare policy making and implementation is very important to the health industry since they (nurses) are primary care-givers who are in direct day to day contact with patients. This means they have a better understanding of healthcare issues and policies that affect patients either positively or negatively hence they can come up with great ideas and points on improving of the sector (Bonuel, Cesario, & Cabading, 2017). Their input in policy formulation is very valuable for the healthcare sector.

Nurses’ unique position as direct care-givers is important while implementing policies since they are the primary participants in the implementation process. In order for any healthcare policy implementation to be successful, it needs the full input and participating of nurses because they work in all areas of the health care sector (Cowen & Moorhead, 2018).   

  •  Institute of Medicine’s five core competencies, how nursing practice can meet each of them and obstacles for each competency as well as ways of overcoming them
  • Provide patient-centered care

Patients should be provided with care that is person-centered. The care-professional should ensure that he/she involves the patient n every stage of the treatment regimen. Patient’s opinions, preferences, values and needs should be identified and included in the treatment procedure to be accorded to them. this helps in ensuring that the outcomes of the treatment are optimal and that patient is aware of how to avoid recurrence of the disease in future (Sherman, Schwarzkopf, & Kiger, 2019). This can be achieved through taking a patient’s personal and health records to have a clear health history of the patient, giving them all details of the treatment regimen, deciding with the patient on the best treatment process and ensuring that follow-up is adhered to.

An obstacle to person centered care is shortage of nurses. This can be overcome by including family members and nominated dependents in the person-centered care procedures. Relatives can help in providing some aspects of the patient’s care that are not complicated and don’t require professional skills (Bonuel, Cesario, & Cabading, 2017).

  • Work as a team

 As part of a larger healthcare sector, nurses should endeavor to work with other healthcare professionals in order to create and harmonious work environment that is capable of implementing policy, providing the best care possible for patients and achieving optimum patient-care results. This can be achieved by ensuring that there are clear and effective communication channels between nurses and other personnel including physicians, pharmacists and others (Bonuel, Cesario, & Cabading, 2017). Exchange of information regarding patient health history and latest health solutions should be made easy and effective.

An obstacle to team work is lack of a team structure and clear communication channels in an organization. This can be overcome by nurses working towards establishing team cohesion with colleagues and other medical professionals (Skiba, Connors, & Jeffries, 2017). They can start by offering to readily share information with other team members and then helping in creating communication and information channels.

  • Employ evidence-based practice

Nurses should integrate the best available medical research and their acquired skills to provide a patient-care that is based on medical evidence and geared towards the patient’s values (Cowen & Moorhead, 2018). They should always use the latest available technology to investigate the patient’s medical problems and use critical thinking skills to interrogate and come up with the correct diagnosis and a treatment procedure that will give optimal outcomes.

An obstacle to this is lack of reliable medical equipment and enough training for the nurses to be able to effectively make decisions based on evidence (Stein & Deese, 2018). This can be overcome by re-training, seeking professional assistance from experienced colleagues and hospitals acquiring the latest medical equipment.

  • Apply quality improvement

Nurses should endeavor to continuously improve the quality if their care duties on patients. They should identify errors and hazards encountered during care and work out ways of preventing them (Sherman, Schwarzkopf, & Kiger, 2019). They should also continually measure the standard of care they provide in comparison with success of the outcomes and work out on how to improve on the same.

This can be achieved through advancing their education and training, seeking professional guidance from experienced colleagues and seniors and incorporating team-spirit in care giving.

An obstacle to improving quality of care is lack of enough skills which can be overcome through the nurse improving their skills by advancing their nursing education and training.  

  • Utilize The Use Of Information Technology

Nurses should use information technology to optimize communication so as to manage the information obtained towards mitigating error incidences hence improve the quality of patient care. Information technology is a great medium through which nurses can obtain, disseminate and relay relevant information about patients and patient-care procedures (Stein & Deese, 2018). If utilized well, informatics can greatly help improve the outcomes of treatment on patients.

An obstacle to use of informatics is the lack of IT facilities in the hospital for the nurse to use. To overcome this, nurses can use the available (limited) facilities like their mobile phones to access and relay the required information (Cowen & Moorhead, 2018).  

References

Bonuel, N., Cesario, S., & Cabading, A. (2017). The need for critical care nursing skills in an acuity-adaptable care delivery system. Critical care nursing quarterly, 33(4), 356-360.

Cowen, P., & Moorhead, S. (2018). Current Issues In Nursing-E-Book. London: Elsevier Health Sciences.

Huston, C. (2019). The impact of emerging technology on nursing care: Warp speed ahead. The Online Journal of Issues in Nursing, 58(6), 132-145.

O’Lynn, C., & Tranbarger, R. (2018). Men in nursing: History, challenges, and opportunities. London: Springer Publishing Company.

Sherman, R., Schwarzkopf, R., & Kiger, A. (2019). Charge nurse perspectives on frontline leadership in acute care environments. ISRN nursing, 17(5), 187-198.

Skiba, D., Connors, H., & Jeffries, P. (2017). Information technologies and the transformation of nursing education. Nursing Outlook, 56(5), 225-230.

Stein, M., & Deese, D. (2018). Addressing the next decade of nursing challenges. Nursing Economics, 22(5), 273.

Stivers, S. (2016). A challenge for nurse-midwifery. Journal of nurse-midwifery, 38(5), 288-292.

Stivers, S. (2018). A challenge for nurse-midwifery. Journal of nurse-midwifery, 38(5), 288-292.

Storch, J., Rodney, P., & Pauly, B. (2019). Enhancing ethical climates in nursing work environments. Canadian Nurse, 105(3), 20-25.

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