Hospital Nursing

Question 1

Nurses aids normally take care of the patients by bathing them, feeding them and toilet them. Every day the nursing staff ensures that they get the patients up and take them to the dining room. The nursing staff usually works alone because they have little or no assistance available. Despite the fact that the limit to nursing staff is 16 nurses’ aide, just about 13 perform direct care. The nursing staff, therefore, is often loaded with heavy duties and rarely completes their cores. Nursing entrepreneurs are the true change agents in nursing (Sullivan, 1999). Entrepreneurs have the virtue of persistence in work and they capture enthusiasm, imaginations and creativity necessary to adapt to new ventures. When nursing becomes a business, it means the nurses practice on a freelance basis and are self-employed. Nursing practice can be done in research, clinical or education as a business. For any healthcare business success, it must have quality services; it must be cost efficient and easily accessible.

Question 2

Nurse’s scope of study and practice is based on specific experiences, professionalism, educational qualifications. These subjects determine the level of autonomy practice. Strategies for enhancing are based on the provision of support for accelerating the professionalism in nursing and a clear expectation for the nursing decision.

Clarification of the expectation on the autonomy

When nurses clearly communicate and organize their work then they can enhance autonomy. This means they will have the freedom to decide on the clinical judgment. For a nurse to describe expected behavior, he has to understand the clinical patient and the art and science of nursing. This may involve, support of independent decision-making and expectation of the nursing action. The nurse’s decision involves interdependent and independent actions. Incorporating the expertise in nursing facilitates autonomous practice into the care of patients. For instance, the organization of patients care units to be judged by nurses based on the recommendation of the treatment plan. If nurses were given an opportunity to make their judgment in the clinical rounds, then this would maximize the contribution of their unique understanding of the care of patients. Investing in the nurse input means the care of patients will be improved, more solutions will be explored, communication improved to supplement the plans.

If autonomous practice is recognized, then this can enhance communicated expectations. Suppose you if you acknowledge excellent performance, you will provide a venue for displaying autonomous practice. Role modeling, rewarding and recognizing exemplary performance by nurses encourages the autonomous actions.  Nurse leaders and specialists should also be involved in behaviors reflective of autonomy. They can also serve as role models and mentoring excellence in performance.  A sample of coaching autonomy may include addressing an unexpected behavior. For example, coachers can compare the expected action and the actual action of nurses and illustrate how to make expected autonomy more explicit. There can always be feed back if nurses do not meet their expectations. In recent studies, it has been confirmed that favorable environment will facilitate excellent autonomy.

Enhance competitive practice.

A competitive nursing expertise will establish a sound clinical judgment. Nursing expertise constitutes skill, knowledge and extensive experience (Jasper, 1994). Autonomy can be foster by creating a learning environment and implementing strategies to enhance competence. If confidence and competence are enhanced, then autonomy will be fostered. In meetings, clinicians can share patient scenarios that can that challenged them. By doing this, they get feedback and advice on how to tackle such complicated patient scenarios. Nurses should be encouraged to participate in continuous examinations to reflect the degree of autonomy that they present in their judgment. Enhancement of autonomy can also be through establishment of an evidence based practice approach.

Strategies that enhance Control over the practice of nursing

Nurses, being employees, must work within the imposed regulations and rules of hospitals. This has profound effect in the work they practice. If nurses sincerely wanted to exercise their practice, they must posses the power to make decisions based on their profession.

Decision-making requires practice

Authorities in power have often dictated Participationory and empowerment management (Wolf, Triolo, & Ponte, 2008). Representatives in an organization are known and all nurses are expected to put some input. Staff nurses are responsible and accountable for solutions and issues discussed in the structure.

The accountability and responsibility of nurses for nurses cannot be stressed adequately. CONP structure is one in which the responsibility for nursing care of patients is placed with staff nurses. This is where many shared governments get awry. In such situations, although a hospital structure is established and nurses are permitted to provide input into key decisions, the ultimate authority for the decision-making continues to reside with managers and administrators.

Question 3

Growth of Knowledge

The growth of knowledge in nursing is centered in creation of a culture and systems whereby nurses collaborate with other healthcare professionals, increasing nursing education and supporting nurses in practicing to the extent of their training and education. In a report, Steven Wartman, the chief executive officer of the Association of Academic Health Centre, said that the future of nursing recommendations is “not surprising”. In that boardroom, Wartman’s speech brought a wider perspective to the discussion. For example, it is advisable to increase the percentage of baccalaureate degree to 80 percent in the next 10 years. In the United States, only 50 percent of nurses meet this target. Wartman suggests that while it is important to increase nurses’ education, it has always been considered as a fractured career. The fracture is known to take place between baccalaureate and the two-year programs.

One of the issues in the report is the consensus model about certification and education requirements.  “The nursing organizations have signed to it” Haller, the vice president of Patient care and Nursing services. The report also suggested doubling the number of nurses with doctorate degree by in the next 10 years.

Fulfilling individual Potential

If the nurses can fully utilize their knowledge in the profession, then increased education would be useful. However, nurses usually confront the institutional policies and government regulations that prevent them from performing to the best of the ability.

The laws that are for or against practice of advanced nursing to examine patients independently, prescribe drugs, and interpret lab tests vary from state to state. How then can we move to a national framework?

In the near future, the need for implementation of consistent practice of advanced nursing laws will be higher. Hill mentioned that they would need qualified professionals to lead in that sector.

Not everyone is with the agreement that advanced practice nurses should take the role of primary care providers. The Dean of the School of medicine, Edward Miller, said that if the rep.............