Professional and Personal Position Statement: Nursing - Coursework Example

Running Head: POSITION MENT Professional and Personal Position ment Professional and Personal Position Statement In order to be prepared for professional practice as a Nurse, an individual must be prepared to complete a wide range of educational objectives. There are several levels of academic education that a nurse can aspire to such as a Bachelor of Science in Nursing (BSN) or an Associates Degree in Nursing (ADN). Either of these will certainly serve as the launching point for a career as an RN, but all academic training must be done at a state certified school of nursing. There are many medically oriented as well as humanities centered courses that prepare the nursing student for a wide range of circumstance when they go on to serve at a hospital or in private practice as an RN (ANA, 2007). Most programs will give the student adequate preparation to perform their duties but it is important to remember that the student nurse is responsible to achieve high academic standing in order to best serve the patients and promote the maximum quality of care possible. After graduation, in order to practice as an RN the student must then take and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN), as provided by the individual state boards(ANA, 2007). These boards also set continuing education (CE) and competency requirements as well as conduct disciplinary hearings. There are other levels beyond traditional RN practice such as: Advanced practice registered nurse (APRN) which is registered nurse who has had advanced educational and clinical practice that have brought him or her to a Master’s level. Nurse Practitioner (NP) who is trained to provided both primary and preventive health care services as well as prescribe medication, and diagnose and treat common minor illnesses and injuries. There are also Certified nurse-midwife (CNM). Clinical Nurse Specialist (CNS) and Certified Registered Nurse Anesthetists (CRNA). Many Masters level and above Nurses also fill important roles in administration and education (ANA, 2007). This paper will concentrate on the professional Registered Nurse and the roles and responsibilities they have and the relationships they must maintain in order to be successful in their practice. The roles and responsibility of the nurse may be simple to state but are often quite complex in practice: Two major themes of nursing obligation return to the work of Florence Nightingale, administrator, statistician, and the founder of modern nursing. Nightingales foundational views of nursing included the development of healing environments as a nursing responsibility and nurses obligations to protect patient confidentiality. Both themes point to an ethics of institutional and social obligations as well as obligations to individual patients. (Aroskar, 1994) An RN must perform many varied tasks in order to provide good quality of care. In beginning the treatment of a patient An RN first performs an assessment by collecting and analyzing information about the patient. This is the primary step in the introduction of nursing care. Assessments include both medical as well as psychological evaluations. They may also include spiritual, economic, social and cultural information that must be used to create a holistic program of care (ANA, 2007). Issues of diversity and cultural sensitivity always need to be addressed in dealing with any situation, whether it is in matters of confidentiality, ethics or treatment planning. There is no generic formula that will fit all of the circumstances that may arise. However, in the study by Hakim and Wegmann, “A Comparative Evaluation of the Perceptions of Health of Elders of Different Multicultural Backgrounds” (2002) they do point to a commonality that may have some potential unifying properties: Health practices are influenced by cultural beliefs and the way people interpret their health. All cultures have some forms, patterns, expressions, and structures of care to know, explain, and predict well-being, health, or illness status. Patterns and beliefs can fall into many similar themes. (Hakim & Wegmann, 2002, p.161) Concerns both small and large, from the way a patient gets along with family members to their tolerance for pain as well as personal, cultural and religious ideologies, must be considered in the overall treatment program. The next duty that a nurse must provide is in the area of diagnosis. This is the nurse’s clinical judgment in regards to the patient’s health conditions or concerns. This diagnosis is concerned not only with the current problems that the patient is experiencing, but the ramifications which those problems may have on the patient’s other health issues, such as poor nutrition, depressive disorders, etc. This diagnosis then becomes the basis for the patient’s care plan (ANA, 2007). The next step is to set recovery goals from the patient and create an outcome plan. This could be a combination of physical therapy (PT), psychological counseling, diet concerns and restrictions, as well as pain management or in some cases palliative care. These are all written into the patient’s care plan in order to assure a continuity of care when other medical, social service or other care professionals are working with the patient. It is then important to make sure that this plan is implemented during hospitalization so that the ultimate patient goal of discharge may be achieved. This is achievedby careful documentation of the patient’s record and all the steps that have been taken and achieved. At each step of care the patient’s progress is carefully monitored and evaluated. Often the care plan is modified depending on the speed, or lack thereof, the patient has achieved in fulfilling his or her goals (ANA, 2007). In practice one of the most difficult tasks that a nurse may face is finding the correct professional boundaries between, the nurse and patient, as well as the nurse and doctor and other coworkers. This can often be difficult and is normally not addressed in the formal education and training of a nurse. Although self-awareness and monitoring, debriefing, and availing oneself of supervision and education are important tools in creating and maintaining boundaries, in the final analysis, the nursing profession needs nurses who have the ability to make decisions about boundaries based on the best interests of the clients in their care. (Peternelj-Taylor & Yonge, 2003) Quite often understanding what these “best interests” are is a growing and changing experience as the nurse goes through years of practice. This is, unfortunately, is often a process of trail and errors and can often result in bad calls and misunderstanding at many levels. More training in this area is certainly necessary. Accountability can also be another confusing issue that can often be misused to pass blame or responsibility onto other parties and never correctly address a situation or a concern of the patient. In fact there are studies that have shown that physicians are often at odds with what should and should not be taught to nurses: Physicians also differed from other professionals as to what they felt should be covered in ethics programs for nurses. They were, for example, least supportive of including discussion of professional accountability. The findings clearly indicate that physicians and practicing nurses and nurse educators view the nurses role in ethical decision making quite differently. Since these are the professionals with whom nurses work most closely, this disagreement could add to the role conflicts nurses experience. (Hilliard, 1990, p. 2) Most training in ethics and accountability has more often than not followed a medical model in the nursing profession. This often leads to the assumption that the role of ultimate accountability and supervision is the physician. This view has often put the nurse in an awkward as well as untenable situation (Hunt, 1994, p. 1). As the physician goes from patient to patient in the hospital setting, the nurse may be the only link to true continuity of care and his or her viewpoint may be ignored because of the authoritative structure of the medical model. This view is changing somewhat and the role of the nurse, and certainly the Nurse Practitioner, is taking on a new scope in the fundamental care of the patient and the administration of the hospital floor and staff. There are, however, many sources of assistance as regards those in any human service profession. The Ethical Standards of Human Service Professionals (Codes, 2004) can certainly be used as the litmus test for evaluating the standards and practices of the nursing profession. Section I Statement 1 states, "Human service professionals negotiate with patients the purpose, goals, and nature of the helping relationship prior to its onset as well as inform clients of the limitations of the proposed relationship" (Codes, 2004, p.68). Negotiate is a key word here. The relationship is always one of give and take and most of all, understanding. There are also issues of informed consent and patient rights, which have several dimensions when dealing with the patient. The first, and probably the most important, is the attempt to ascertain the cognitive capacity of the patient in determining his or her own care and treatment. Many patients, for one reason or another, not only have physical limitations, but accompanying cognitive impairments that may make their judgment suspect and require the need for further investigation. Another often ignored aspect of training for the nurse is in the area of communication and more specifically writing skills. In a journal article by Lee A. Spears entitled The Writing of Nurse Managers: A Neglected Area of Professional Communication Research shows that a nurse will spend between twelve and sixteen hours of a forty hour work week writing a wide range of different communication for vastly different people from physicians to patients with little education. In fact, “Most of the managers evaluated their undergraduate training in professional writing as inadequate and perceived a need for formal instruction in this area. The documents I examined bore out this need” (Spears, 1996). References American Nursing Association. (ANA). (2007). Retrieved January 27, 2008, from American Nursing Association Web site: http://www.ana.org Aroskar, M. A. (1994). Ethics in Nursing and Health Care Reform: Back to the Future?. The Hastings Center Report, 24(3), 11 Codes of ethics for the helping professions. (2004). Ethical standards of human service professionals. Belmont, CA: Brooks/Cole. Hakim, H. & Wegmann, D. (2002) A comparative evaluation of the perceptions of health of elders of different multicultural backgrounds. Journal of Community Health Nursing, 19 (3), 161-172 Hilliard, M. T. (1990). Nursing, Ethics & Professional Roles. The Hastings Center Report, 20(1), 2. Hunt, G. (Ed.). (1994). Ethical Issues in Nursing. New York: Routledge. Peternelj-Taylor, C. A., & Yonge, O. (2003). Exploring Boundaries in the Nurse-Client Relationship: Professional Roles and Responsibilities. Perspectives in Psychiatric Care, 39(2), 55 - 59 Spears, L. A. (1996). The Writing of Nurse Managers: A Neglected Area of Professional Communication Research. Business Communication Quarterly, 59(1), 54 Read More