NRS-430V Contemporary Nursing Practice
Contemporary Nursing Practice Bottom of Form
The healthcare system has advanced over the years towards the provision of better services leading to desirable patient outcomes. This change has been drastic among nurses. New regulations boosting access to healthcare services and improving patient outcomes without compromising the quality of services provided have expanded nursing roles. A paramount shift in nursing education has led to greater problem solving and critical thinking skills. Increased utilization of current technology and informatics has revolutionized how nurses provide their services at the clinical level (Cherry & Jacob, 2019). Generally, registered nurses (RN) have adapted to the evolving environment around the healthcare system. This assignment will comprehensively analyze the changes that have taken place to revolutionize nursing practice towards the provision of better care services.
The Evolution of Nursing Practice
In its most basic form, a nursing practice began at a home back in the 1840s. during this period, there were no hospitals, and as a result, patients were being taken care of at home by their family members (Nazir, Levy, Rudolph, & Unroe, 2017). Gradually, women started acquiring training to become caregivers in minor to moderate hospital systems. The training could last for about two to three years before one could become a qualified nurse. With time, these hospitals expanded as nursing education became more comprehensive. Consequently, technology was introduced in the form of stethoscopes, advanced patient beds, and blood pressure devices. However, as medicine and technology advanced, the need for more education became very necessary.
Currently, nurses are expected to attend college and even take part in special nursing specialist programs first, then join the hospital environment. Consequently, nurses under training are expected to work under the supervision of RN to gain experience for them to graduate. The training also goes on even after graduating, to gain more knowledge and skills (Nazir, Levy, Rudolph, & Unroe, 2017). Technology has also advanced such that health records are now being stored electronically, with all types of new devices such as X-rays and CT scans. The future is even expected to be more advanced than the current practice.
Differentiated Practice Competencies
Both graduates of Bachelor of Science in Nursing (BSN) and Associate Degree in Nursing (ADN) practice as RN. However, their level of knowledge and skills acquired differ, hence differentiating their roles in clinical settings. BSN programs focus more on research and informatics, with more time allocated towards clinical rotations in public and community health settings (Matthias, & Kim-Godwin, 2016). They are more competent in carrying out procedures and assessments in acute care settings. ADN program on the other hand is task-oriented with more responsibility for actions taken. They possess better assessment, planning, and implementation skills and hence play a significant role in taking care of a patient from the point of adding to discharge. ADN nurses also administer basic clinical procedures and monitor patients, while updating their charts in day to day care of patients.
Patient Care Situation
In a patient care situation such as a surgical patient, nurses with BSN have recorded a lower failure-to-rescue and mortality rate as compared to ADNs. This is as a result of the differences in their approaches to patient care. BSN program is designed to enhance better critical thinking and analytical skills, when handling such a patient, in addition to extra procedures that cannot be taken by ADN nurses (Cherry & Jacob, 2019). As such, BSN nurses will observe better patient safety skills with a positive outcome as compared to AND nurses.
Evidence-Based Practice in BSN Education
Evidence-Based Practice (EBP) is aimed at translating the current knowledge into the daily care decisions to better care processes and patient outcomes. Consequently, through EBP, nurses can keep up with current medical protocols for better patient care. As such, the current nursing curriculum has incorporated EBP into the RN-BSN program, where graduates are educated on the roles of research in nursing practice (Horntvedt et al., 2018). The program entails methodologies, design, processes, and ethical tenets of research. Additionally, BSN nurses are equipped with appropriate critical thinking skills utilized in evaluating and critiquing research studies to apply the findings in their daily clinical practice.
In the current healthcare system, care delivery involves various interfaces and patients’ handoffs amongst several healthcare professionals with different education and occupational training levels. Within only a 4-day hospital stay, a patient can interact with more than 50 different hospital staff including pharmacists, physicians, nurses, and technicians among others. Effective clinical practice thus requires accurate communication of critical information across this interdisciplinary team (Buljac-Samardzic et al., 2010). To enhance effective communication, nurses are encouraged to take part in other departments’ training for more insight into their roles at the clinic. This way, it will be possible to assess situations with numerous viewpoints giving room for better decision making, hence improving patient safety and outcome. Consequently, it is necessary to promote multidisciplinary rounds while keeping focus on the patient to improve communication between departments.
The current healthcare system is dynamic with advanced technology and practices now and then to better the quality of care provided. Nurses being part of the frontlines in the changes happening have thus adapted and incorporated even more advancements in their education curriculum to prepare graduates for unforeseen changes in the future. This gives room for evolution and advancement in the nursing profession while maintain and improving the quality of care proved.
Buljac-Samardzic, M., Doorn, C. D., Maynard, M. T., Reiter-Palmon, R., Kennel, V., Allen, J., & Jones, K. J. (2010). Good Catch! Using Interdisciplinary Teams and Team Reflexivity to Improve Patient Safety. (Group & organization management.)
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Matthias, A. D., & Kim-Godwin, Y. S. (2016). RN-BSN students’ perceptions of the differences in practice of the ADN- and BSN-Prepared RN. Nurse Educator, 41(4), 208-211. DOI: 10.1097/NNE.0000000000000244
Nazir, A., Levy, C., Rudolph, J., & Unroe, K. (2017). Evolution in nursing home research: Forming collaborative groups. Caring for the Ages, 18(4), 6-7. https://doi.org/10.1016/j.carage.2017.03.007
Contemporary Nursing Practice
Nurses remain at the core of effective care provision and a growing profession because of its evolution. The need for advanced education and training, ensures that nurses are well positioned to deliver care in a transforming health industry. Today, professional nursing entails specialization and scopes of practice based on one’s clinical skills, capabilities, and competencies. The use of innovative care models and evidence-based practice implores nurses to advance their education, focus on patient care, and work in teams to enhance quality and delivery of patient care (Graebe & Chappell, 2019). The purpose of this essay is to evaluate contemporary nursing practice and evaluate how it has changed over time and its position today in health care system.
Changing Nursing Practice and The Effect of the Evolution On Scope of Practice & Patient Treatment
The nursing profession has witnessed several changes since its establishment. Originally, nursing was about caretaking and caregiving roles that were assigned to women. The women did not have formal training or nursing education. In most instances, they were housewives and possess skills and knowledge transferred from family members who had the desire to care for the sick. The scope of their practice was not limited (Salmond & Echevarria, 2017). These women treated patients as guests in their homes. However, things changed and have been transforming since the Crimean War when Nightingale made nursing a distinct model to care for the wounded soldiers by writing “Notes on Nursing in 1854. The Civil War of 1861 also demonstrated the increased role of nurses based on women who followed their husbands, brothers, and fathers to care for them. The main responsibilities of these women included ensuring that the patients were comfortable and reported any issue to physicians.
The initial concept of nursing emanated from these two critical events as physicians wanted trained women who became nurses. Hospitals began programs to train nurses as caregivers. These programs defined the scope of practice for the nurses. By end of 19th century, many hospitals had their nurse training programs but were not standardized (Graebe & Chappell, 2019). Over the next century, nursing practice evolved and changed leading to a contemporary nurse who is expected to use evidence-based practice (EBP) interventions, be a critical thinkers and highly trained and educated. Nurses are today better equipped and have increased scope of practice based on their specialties. The provision of advanced education has enhanced their training and allowed them to think more critically and enabled them to conduct more role in clinical setting. Nurses are not primary care providers in certain regions, have better skills and control the treatment process while advocating for patients to enhance overall care outcomes.
Differentiated Practice Competences Between Associate and Baccalaureate Nursing Education
In comparing the practice competencies of associate and baccalaureate nursing education, the BSN-prepared nurses are considered as professional nurses while associate-degree trained nurses are technical nurses. Further, ANDs are trained primarily on clinical skills while BSN have more focus on nursing research, clinical skills, and management. Both qualifications equip nurses with essential skills focused on meeting accepted patient care standards. However, BSN nurses are more focused on disease prevent, advocacy, research, community health, and execution of best practices.
They also examine or evaluate data and informatics and generating effective solutions to patient outcomes based on their scope of practice (Salas et al., 2018). On their part, the scope of ADNs include basic nursing care that includes recording patient’s history, recoding symptoms, and utilizing simple medical equipment as well as provision of patent education on disease prevention, healthy living and respecting physician appointments and medical reviews. In summary BSN-trained and prepared nurses have more varied differentiated practice competencies and expanded scope of practice compared to those with AND qualifications.
Patient Care Coordination
BSN-trained or prepared nurses have a different approach to nursing care and decision making when dealing with patients in care situations (Salas et al., 2018). For instance, a patient presenting with chronic conditions like diabetes may implore on the BSN-trained nurse to make better decisions and take effective actions compared to the ADN nurse. A patient with type II diabetes may experience chest pain and shortness of breath. The patient has an NPO directive as he is scheduled for surgery at 9 am the following morning for catherization of heart. The patient takes Eliquis twice daily since getting a stent in the heart. He also takes Clonidine for chronic hypertension. The vitals show elevated blood pressure of 108/60. The patient should be given insulin per sliding scale ACHS. However, at 7am, the patient experience a FSBS of 150mg/dL. In this case, the ADN nurse may give Eliquis which is an anticoagulant medication at 9pm since she may not be aware that research evidence shows that having anticoagulant medication 12 hours or more before surgery reduces the risk of fatal bleeding. The implication is that a BSN nurse is likely to handle the situation differently by not giving these medication and insulin because of the risk they portend for the patient.
The deployment of evidence-based practice is important in delivery of quality health care to patients since it is founded on knowledge and research evidence as well as clinical trials. Through EBPs, hospitals offer more reliable and high-quality patient care. Nurses enhance their critical thinking skills, enhance their observation and procession of information while practicing and brainstorming ideas to make necessary improvements in care delivery (Verot et al., 2021). The academic preparation of the RN-BSN nurse supports the application of EBP as it prepares nurses to use evidence coming from research to make better care decisions and apply their critical thinking skills in different patient situations. The BSN also supports EBP in nursing by training nurses on leadership, management and effective communication as well as having scientific research skills.
Communication and Collaboration with Interdisciplinary Teams
Nurses are effective communicators and collaborators in care delivery. Nurses communicate and collaborate with interdisciplinary teams using different approaches. These include using electronic approaches, handwritten notes, texts and emails (McMenamin et al., 2019). Further, the integration of health information technologies has improved communication and collaboration among these teams as nurses can use electronic health records, telehealth and telemedicine means and teleconference to communicate not just with professionals but also patients and deliver quality care.
Nursing remains the foundation of patient care. The profession has transformed and continues its transformation for better care delivery. Nurses are at the forefront of care provision and advanced education allows them to be primary care providers in different care settings. ADNs and BSN-prepared nurses have different approaches to care provision for patients in diverse situations. therefore, by leveraging on EBP interventions, the contemporary nurse is well-positioned to offer quality care in a transforming healthcare system.
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