Nursing is a profession that constantly evolves to improve itself. There is a high demand for nurses all across America. Excellent nursing practice is achieved by understanding the history of nursing and integrating the milestones achieved with the present practice. Through advanced education and new technology the nurse can provide the patient with the best care and promote community health. Knowledge gives us power to change and advance in healthcare. My mission is to demonstrate excellence in clinical care by my commitment to evidence-based practice research, continuing education, and by delivering culturally competent patient care in a caring and healing environment in accordance with the nurse practice act.
The Board of Nursing (BON) is a regulatory agency that functions to protect the public as well as govern the safe practice of nurses. Every state has a board of nursing that mandates the nurse practice act be properly carried out. Nurse practice acts define the scope of nursing, how to obtain licensure, how to lose licensure, and the consequences of practicing without a license. The makeup of the nursing board and its responsibilities come from the nurse practice acts also. The BON is responsible for reviewing the nurse practice act to ensure that minimum standards of practice are defined. The BON also approves nursing education programs, evaluates applicants, issues licensure, and disciplines those who violate the law (Pearson Education, 2010). To obtain a nursing license in South Carolina I am required by the BON to have demonstrated competency in performing regulated activities that are complex, require skill, and independent decision -making.
This is determined by showing verification of graduating from an approved Registered Nurse education program, passing the national licensing test, and passing a criminal background check. In order to renew my license biennially I must go through the BON and show verification of competency and the number of hours practiced as evidenced by my employer certification on a form approved by the Board. If I fail to comply the renewal requirements the BON may deny my application for renewal. Also, abiding by the nurse practice act and refraining from unethical decisions such as; using drug and alcohol at work, diverting narcotics, and abusing patients I am able to remain in good standing with the BON and abstain from any disciplinary action from the BON.
The American Nurses Association (ANA) is a Professional Nursing Organization that provides nurses a variety of resources to support their careers. The ANA offers leadership positions within the organizations and workshops for continuing education as well as employment resources. Conferences are held within the organization to network and congregate about healthcare reform. Although the ANA does not offer any legal authority to grant licensure or enforce practice policy, it carries the voice of the nurse and the public to the regulatory agency to evoke change (ANA, 2013). I currently am not a member of the ANA, but I plan to join.
Being as though I am a nurse that works in the emergency department I feel the need to voice concerns I have in dealing with patient care and staffing issues. I also would like to have a voice in addressing safe nurse to patient ratios in the emergency department. The ANA can help with these issues I face by helping to promote the interests of nurses to state and federal legislative bodies like the BON. I feel this organization can help me obtain the education I need in directing me to online courses offering continuing education credits and assist me in special credentialing such as obtaining a Certified Emergency Nurse certificate.
Nursing ethics are a set of standards concerning the actions of the nurse in his or her relationship with patients, patients’ family members, other healthcare providers, policymakers, and society as a whole (Cherry & Jacob, 2011). One provision from the code of ethics that influences my practice is “The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development (ANA, 2013). Although patient care is of the utmost importance nursing can’t be practiced without the appropriate knowledge required. Evidence-based practiced research is such an important component to nursing. Without the continuous studies of such research progress would not be made in healthcare advancements.
As a nurse that has worked in the emergency department I have engaged in educational opportunities offered by the emergency department has helped with quality improvement initiatives and increased patient satisfaction scores. A second provision that has influenced my practice in nursing is listed as “The nurse’s primary commitment is to the patient, whether an individual, family, group, or community (ANA, 2013). “ Many times in the emergency department families and friends are surrounding their loved one. It is the nurse’s primary duty to advocate for the patient. Many times families have other ideas of healthcare that the patient is not interested in. This is where communication and education is imperative between all involved. Also, if the patient refuses any type of care education is the best answer and then acceptance if the refusal is ongoing. Honoring the patient’s wishes as long as patient safety is not an issue must be upheld in the nursing profession.
The ANA Code of Ethics consists of several traits that should be the underlying basis from all professional nursing practices. As a nurse one must interact with a multidisciplinary team to reach optimal results for a patient’s outcome. One of the trait’s that is important is mutual respect. In an Emergency Department I work with several entities all of which have the patient’s best interest at heart. Collaborating, listening, supporting, and implementing goals are all part of having mutual respect for the team members as well as the patient and patient’s family. Another trait that is important is confidentiality. Privacy is an essential code of ethics. Discussing pertinent issues about a patient is restricted to those directly involved in patient care. Many times individuals try to call the emergency department and get updates on patients.
I follow the laws in my setting regarding this issue. A third trait would be having respect for human dignity. This is important in the emergency department when patients are too sick to move. Many times patients soil themselves and feel embarrassed. We as nurses must acknowledged their feelings in a therapeutic way. We must maintain professional and never judge the patient in these instances. A fourth trait I possess would be accountability. I take full responsibility to abide by the nurse practice act in my state. I follow the requirement for licensure renewal and take continuing education classes pertinent to my work area. I also am accountable for the nursing care of patients and to practice using the standards of care in my hospital. If I make a mistake I am held accountable for my actions and report any incidents to the appropriate personnel.
Jean Watson’s Theory of Human Caring plays a significant part in promotion of a patient’s health. This theory suggests that there are carative factors that are the core to nursing. It is a holistic outlook that addresses the impact and importance of altruism, sensitivity, trust, and interpersonal skills (Cherry & Jacob, 2011). Caring is a key element of the patient’s outcome. Possessing a caring heart sets the bar high in healthcare. “The transpersonal process of caring, or caring among, nurse, environment, and client, is essential to healing” and the nurse is the tool that “implements these carative factors, that facilitates, and promotes” the restoration of the patient health (Cherry & Jacob, 2011).”
Jean Watson’s Theory of Human Caring fits in my professional practice daily. This model helps to establish a trusting rapport between you and the patient. When dealing with patients on an everyday basis the nurse is the one who interacts with the patient the most and sets the tone for the relationship. Compassion and human touch are necessary for positive patient outcomes. Following this module reminds me and helps me to improve my delivery of care by allowing patients to communicate feelings while I actively listen to their needs. When I enter a patient’s room I survey the scene or take a holistic approach. I want to let this patient know I care about all of their needs and not just the medical concerns. The theory states “interconnectedness of one human touching or caring for another is a carative factor which promotes restoration of health and equilibrium” (Cherry & Jacob, 2011).
After I introduce myself to the patient I immediately ask them how they are feeling or if there is anything that they are concerned about. I feel this gives the patient the opportunity to discuss concerns and allows time for therapeutic communication establishing a trusting nurse to patient environment. Watson’s carative factors help with caring or maintaining health even when a patient is terminal. I instill this theory through offering chaplin services to patients or assistance finding mental support for those that are terminal. I come in contact with many different cultures in the emergency department and it is important to recognize the need for teaching and making it conducive for the patients to learn about their medication or disease process. Using a language lines shows the patient that you care about their health and education.
Florence Nightingale was inspirational and changed the face of nursing across the world from a career many looked down upon to a highly skilled and respected medical profession by implementing standards in healthcare and training others for the occupation. After witnessing the unsanitary conditions during the Crimean War she obtained hundreds of scrub brushes and asked nurses and the least sick patients to scrub the inside of the hospital from floor the ceiling (The Biography Company, 2014). Her compassionate, dedicated, and skilled work helped her to reduce the hospitals death rate by two-thirds from implementing “The Environmental Theory” into her practice (The Biography Company, 2014).
Florence was a nurse that was able to look outside the box and critical think to find solutions to better healthcare. After learning of her great achievements the one I use most in my healthcare setting is following sanitary measures. The spread of bacteria is very prevalent among the emergency department and by adhering to hand hygiene principles and other core measures to keep from the spread of disease I feel her testimony sets the stage for mostly all healthcare employees. Also, through her courage and compassion for humanity she helped to mold my nursing practice into one of diligence.
Respect for autonomy comes to mind when I think of a case scenario. Upon triaging a patient with their significant other in the room I came across the medical history section. This may cause concern for some patients being as though we must obtain a full medical history. I explained to the patient that I have personal questions to ask her and needed to know if she would like to be alone during this process. The patient stated she would like her significant other to leave the room. When interviewing the patient they informed me that they did not want their history disclosed to the significant other or any of the results of testing that day. I appreciated this request and then informed the significant other that they must remain in the waiting room until testing was finished and that it would be up to the patient to notify them of updates.
Beneficence is the principle of providing good to someone whereas non-maleficence addresses the risk of a procedure to cause harm to a patient (Cherry & Jacob, 2011). An example of beneficence I encountered was when an elderly patient was scheduled to have a cardiac catheterization performed. While performing the pre-op measures for this patient it was observed that this patient had an area of breakdown on his skin and an elevated temperature. I immediately called the cardiologist and informed him of the findings. He came to talk to the patient and decided to reschedule the procedure for another day when he was afebrile. Without reporting the finding to the doctor the patient could have introduced infection into the bloodstream and could have became septic with critical results.
ANA Nursing World. (2013). Retrieved from https://www.nursingworld.org Cherry, B., & Jacob, S. (2011). Contemporary Nursing: Issues, Trends and Management, (5th edition). St. Louis: Mosby Elsevier. Florence Nightingale. (2014). The Biography.com website. Retrieved from
http://www.biography.com/people/florence-nightingale-9423539 Pearson Education. (2010). Retrieved May 8, 2015 from http://wps.prenhall.com/chet_sullivan_effective_6/21/5493/1406300.cw/content/index.html
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