Individual Analysis Paper
There are many factors that influence and guide the registered nurse (RN) in her daily nursing practice. These factors include state laws, professional requirements and responsibilities, and personal belief systems and values. All factors work together to provide competent, safe, and quality care for society as a whole. It is vital that the RN possess both awareness and understanding of the important role these factors play in his or her daily practice. The Scope of Nursing Practice
The American Nurses Association (ANA) defines the Scope of Nursing Practice as, “the description of the who, what, where, when, why, and how of nursing practice that addresses the range of nursing practice activities common to all registered nurses (2010, p. 67).” The individual RN’s degree level, knowledge base, employment position, and patient population all determine the range to which he or she is able to work within the scope of practice (ANA, 2010).
Effectively working within the full scope of practice requires the RN to be able to address all physical, social, spiritual, and emotional needs from admission to discharge; by means of patient advocacy, individualized teaching, treatment planning, and utilization of family and social support systems (Oelke, Besner, Doran, McGillis-Hall, & Giovanetti, 2008). Working on a behavioral services unit allows me to completely address the full range of patient needs on a daily basis. I collaborate with mental health professionals to address psychological needs, medical doctors to manage and treat physical conditions, social workers to deal with housing and family issues, and pastoral care to address the patient’s spiritual matters. I believe that issues of mind, body, and spirit must be equally addressed for complete patient care. Legal Regulations
The Ohio Revised Code sets the legal standards through which a nurse is permitted to practice. Nursing laws are mandatory rules of behavior, and when broken can result in punishment, or even the loss of the RN’s nursing license. The Ohio Board of Nursing is responsible for the licensing all nurses, as well as for ensuring that all nursing standards are maintained. As an RN it is vital that I understand the legal limits to my nursing practice. For example, I cannot legally prescribe medications, but I have
the authority to administer medications under the supervision of a licensed physician. Always practicing within these defined limits assures safe patient care, nursing competence, and protection of the RN’s license. The Development of Practice
The Code of Ethics for Nurses was developed as a guide for carrying out all nursing responsibilities in a manner consistent with quality nursing care and the ethical obligations of the profession (Fowler, 2010). I will be discussing provisions seven, eight, and nine of the nursing code of ethics. Provision seven requires nurses to contribute to the promotion of the profession through involvement in the workplace, the maintaining of professional standards, and the participation in academic activities (Fowler, 2010). As an RN I have not contributed to the promotion of the profession through workplace involvement. I have had numerous opportunities to join work related committees, mentoring programs, or participate in the orientation of new RN’s.
Until now have refused based on the fact I am enrolled in school. I was recently approached by my nurse manager and asked to help orient a new class of RN’s. I accepted the challenge and will start the orientation process in late September. Provision eight necessitates that all nurses work inter-professionally with other health care professionals, as well as with the community, to meet all health care needs on a municipal, federal, and global level (Fowler, 2010). Nurses must possess an understanding of both global health issues, as well as community health concerns. Working on a behavioral services unit, means that I frequently deal with the homeless or shelter living populations of my city. As nurse I know that this patient population is more susceptible to preventable communicable diseases. I work hard to encourage any patients who either homeless or live in local shelters to take advantage of the hospitals flu and pneumonia vaccines.
My effort in this area helps maintain public and personal health, as well as prevent the spread of communicable diseases. Provision nine dictates that the entire nursing profession and all of its associations are accountable for upholding the integrity of the profession, the promotion of nursing values, and influencing social course of action (Fowler, 2010). It is vital that all nurses hold themselves, their peers, and other healthcare professionals to the utmost level of integrity and professionalism. I must admit that this I find this provision to be the most challenging for me professionally. I have no problem holding myself to the highest professional standards, but have a hard time holding my peers to the same standard of care. Recently, a peer chose not to medically address a patient’s incredibly high blood pressure. She reported to me that it was merely a side effect of the patient’s agitation, and assured me the high blood pressure was being controlled with an antipsychotic. I could not believe what I was hearing, and immediately called a medical doctor for help. In retrospect I should have had the courage to both confront my peer’s lack of concern, as well as report her disregard for the patient’s well-being. Philosophical Beliefs
Philosophy is defined as, “the intense and critical examination of beliefs and assumptions (Burkhardt & Nathaniel, 2008, p. 27). Philosophy can be further divided into the philosophy of knowledge and the philosophy of practice (Burkhardt & Nathaniel, 2008). The philosophy of knowledge concerns suppositions regarding truth and disagreement, and the philosophy of practice concerns suppositions regarding behaviors and morals (Burkhardt & Nathaniel, 2008). Philosophical beliefs can affect they type of care that the patient ultimately receives.
If the nurse is not able to see the patient as an autonomous individual, care will ultimately be substandard. Part of my work as a psychiatric RN is helping patients deal with drug and alcohol addiction issues. Over the course of my nursing career I have helped hundreds of patients go through drug detoxification. Because my department deals with a lot of recidivism, it is very easy for a nurse in my role assume that all drug addicted patients are unmotivated in maintaining sobriety. I must always be on guard against developing a jaded attitude about my patient’s chances for maintaining his or her sobriety. If I assume the patient is not committed to his or her sobriety I may give end up giving substandard care. Before the start of each shift I remind myself that each patient is an individual, and must not be judged based on my own assumptions or personal experiences. How Ethics Influence Nursing Practice
Ethics is a moral philosophy, a deliberate opinion of right and wrong (Naman, Nystrom, & Eriksson, 2012). Two ethical theories related to nursing
are utilitarianism and deontology. The theory of utilitarianism believes that all ethical decisions should be based on the greatest benefit to the greatest number of people, and theory of deontology believes that all ethical decisions should be based on what is best for the individual person (Burkhardt & Nathaniel, 2008). Nursing values include: kindness, truthfulness, fairness, discretion, independence, loyalty, and nonmaleficence (Burkhardt & Nathaniel, 2008). The RN’s understanding of her own personal values is required for the delivery of quality care, because the art of caring manifests itself as a personal value (Nasman, Nystrom, & Eriksson, 2012).
As a psychiatric RN on an acute behavioral unit I frequently care for the underserved population of my community. Most of my patients have a history of violence against peers, are uninsured, homeless, or abused. Caring for this cross section of society can be challenging to say the least. It is necessary that I as the RN approach each patient as an individual; deserving of kindness, patience, and honesty. This approach treats each patient with the respect and dignity he or she deserves. On several occasions my patients have told me that I cared for them better than their own parents. I believe that all patients are entitled to the highest quality of care regardless of their current psychosocial standing.
Many factors play a role in the individual nurse’s daily practice and quality of care. It is vital that the RN professionally act within the legal standards and limitations set by forth by state laws. The RN must always strive to work fully within his or her scope of practice. Individual understanding of the code of ethics is fundamental in maintaining the integrity of the profession for all nurses. Awareness and self-assessment of the RN’s personal philosophical beliefs and value system are fundamental in providing quality care to all patients. When the RN has an understanding of all of these factors, quality patient care is assured.
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Topic: Individual Analysis
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