Exploring the Influence of Nursing Professional Practice on Organizational Quality - Essay Example

?  Primary Nursing              Primary Nursing Introduction There is a tremendous variation between primary nursing in the present day from the nursing practices in the 1960. At the moment, nursing necessitates a more advanced benchmark and level of educational qualification than in the previous period, specifically, 1960. It may be logical to assert that the degree of qualification required to become a practicing nurse is the master’s level, from a proficient higher education institution. The issue with this kind of qualification requirement in the medical arena is that, by the time learners aspiring to be nurses attain the requirement to be nurses, they can be overwhelmed by the responsibilities bestowed on nurses. In the past, it would be workable to have health experts, for example, doctors admit patients to health institutions as a favor to the families of the patient (Manthey, 2002). In addition, it would be less complicated to find people with little or no nursing qualification leading the nursing field in a health institution. Ever since 1960, this situation has dramatically revolutionized since that period. The level of education is augmenting, the workforce is increasing in diversity, and the nursing profession is rising progressively. During the 1960 period, influential nurses, for example, Marie Manthey comprehended that the care nurses offered in health institutions needed to be concentrate on family and patient centered model instead of focusing on a task oriented approach (Boltz, 2011). Moreover, Marie Manthey also proposed that this model required being the foremost strategy for providing nursing care because it supported relationship establishment with families and patients that could promote better and extra specialized care strategies in addition to favorable care results (Manthey, 2002). This paper will look at Primary nursing today in comparison to 1960. The paper will evaluate literature regarding this subject, its influence to nursing leadership, and a number of recommendations. The advancement toward primary nursing a strategy of health care service delivery was initiated in the 60s and has been progressing since that period. In addition, this advancement has been recapped in a number of documents created during this time. The concept of primary nursing was largely urged on by a deficiency of medical practitioners. The foremost documented training for nurse professionals was established by a nurse, Loretta Ford, and a physician, Henry Silver, in 1965, with an aim of rectifying the ineffective distribution of heath resources, stabilizing health care costs, and enhancing the number of health care givers. Also, there was a degree of mystification about the different abilities and titles of nurses as the profession was established (Weber & Kelley, 2009). This has continued as the responsibilities and authority of the nursing practitioners have changed over time. In the 1960’s, there was a personal connection between patients and nurses that many old practitioners miss in the present nursing practice. Literature Review Friedberg, Hussey, and Schneider analyzed the hints of explaining primary care in their assessment of the proof with regard to its effectiveness (Friedberg, Hussey, & Schneider, 2010). They concentrated on a number of general explanations of primary care. In the foremost explanation, primary care was explained as a specialty and those offering it, for example, family physician, general internists, general pediatricians, and other generalists, were specialists (Friedberg, Hussey, & Schneider, 2010). A second explanation specified a number of health care activities; care coordination care for a large number of providers, first-contact care for new health issues, long-term person-centered care, and comprehensive care for a big number of health problems, all given at a standard source of care (Friedberg, Hussey, & Schneider, 2010). The third explanation described primary care with regard to the course of the health system. The authors concluded that the most appropriate proof both supports enhancing the capacity of providers to realize primary care responsibilities and orienting the health system in the direction of primary care. They also warned against strategy simply intended at enhancing the number of primary care givers without orienting the health system. Finally, they asserted that use of primary care and expectation of the members of the public should be dealt with as in, for example, persuading patients to go to primary care givers as initial contact for existing symptoms (Friedberg, Hussey, & Schneider, 2010). Swokowski, Jovie, Jorgensen and Calaway explain the manner in which primary nursing was instituted into a chronic haemodialysis service. The foremost functions of the primary nurse are recorded as the condition of clinical information to individuals who are engaged in caring for patients in the absence of the primary nurse, introducing the stages in the process of nursing when setting up care for patients, execute planning if necessary, and availing details to individuals in the problem-oriented medical record. In the primary nursing model explained by Swokowski, Jovie, Jorgensen and Calaway, a nurse carries out all the care responsibilities for designated patients. In the nonattendance of the primary nurse, the patients are taken care of by a principal unit of associate primary nurses (Dobson & Tranter, 2008). The authors assert that the execution of this primary nursing model has caused the nurses having an enhanced knowledge of the patient, thus, having the ability to offer more effective and applicable patient centered nursing. In addition, primary nursing care in haemodialysis units has been illustrated as having both negative and positive consequences. Quirk highlights the progress and consequences of primary nursing units in a chronic haemodialysis outpatient unit. A reduction in venipuncture infiltration was utilized in the assessment of clinical results. Episodes diminished from a monthly mean of 17.8% to 7% after the establishment of primary nursing units. In addition, there was also tremendous escalation in the efficiency of dialysis. Also, the primary nursing model was positively assessed by patients and staff. Illumin illustrates a planning technique for primary nurses in haemodialysis which acts as a patient and educational guide. Also, Illumin illustrates clear communication, need for education, and autonomy as foremost components of primary nursing in the setting of haemodialysis. Primary nursing is explained as the standard technique of coordinating care in haemodialysis units in America but Quirk argues that functional care delivery, in which it is not extraordinary to have varying task every day, is carried out in a number of units (Hayman, Ciof? & Wilkes, 2006). In a report published in the year 2007, the Fellows of the American Academy of Nurse Practitioners indicated that the description of primary nursing left out non-physicians from the description of primary care provider. The practitioners instead proposed the description of the primary care provider developed by the Institute of Medicine Committee on the Future of Primary Care. The institute defined it as “Clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community,"(Fellows of the American Academy of Nurse Practitioners, 2007, expression Steps toward patient centered care). The committee observed that for forty years, nursing practitioners have been offering primary care in a wide range of collaborative strategies that pre-date the primary nursing. Gardner undertook a comparative research for five years investigating primary nursing and team nursing and determined that there was no dissimilarity that existed in the stress levels of nurses in primary nursing and team nursing. In this identical research, the retention of staff in the units utilizing primary nursing was longer than the units utilizing team nursing. In addition, primary nursing seems to get a by and large positive reaction and has been presumed to be the most patient centered model (Fraser, Eades, Glackin & Holmes, 2002). Primary nursing has also been illustrated as advancing the status and role of nurses. Influence to Nursing Leadership A number of nurses have practiced separately from medical doctors since 1960, specifically in disciplines external to the conventional medical practices, for example, nurse midwifery. The prospects for nurses in primary care advanced as the United States was going through a shortage of physicians after the adoption of the Medicaid and Medicare programs in 1965, which prompted improved demand on the health care system than in previous time. The University of Colorado initiated the foremost nurse practitioner educational program in America. Other institutions also followed the trend rapidly. The population responded positively to the novel nurse practitioner roles and programs that advanced from Colorado’s program and different creative educational nurse practitioner program that ensued. This promoted the responsibilities of nurses in the field of medicine (Weber & Kelley, 2009). As qualified health care experts, nurses share a dedication to giving first-rate care. Currently, a number of health professionals are beginning to perceive nurse practitioners as playing a critical and complementary duty in primary care. Nurse practitioners give health care services in a way that lays emphasis on assessment of the patient in his surrounding to further their treatment and diagnosis. This has an impact on nursing leadership as it gives emphasis to treatment of illness in the circumstance of a complete well being of a patient and promotes patient education (Weber & Kelley, 2009). Presently, a nurse practitioner has the ability to provide a number of services, for example, diagnose and treat health problems, obtain medical histories and undertakes physical examinations, prescribe medications and additional treatments, and managing cases and coordinating services. Recommendations One, to correct the issues that collaborative agreements cause to independent practice, areas that have already not done so should permit nurse practitioners to carry out their duties autonomously by removing state-level constraints to nurse practitioners area of practice. Obligatory collaborative agreements must be brought to an end, giving nurse practitioners the chance to offer autonomous primary nursing while employing the complete aptitude of their training. As a result, nurse practitioners could exercise carefulness to work with other health experts where collective decision making is advantageous to a specified patient receiving care. Two, areas that do not contain a law describing the scope of practice should bestow the power to define the scope of a nurse practitioner or its enforcement in a Board of Nursing, and not the Board of Medicine. Board of Medicine is headed by physicians who are not willing or well informed to acknowledge the primary nursing capacities of nurse practitioners (Weber & Kelley, 2009). Three, nurse practitioners should go past imparting alternatives, benefits, and risks associated to treatment and diagnosis. Also, nurse practitioners should update the patients on their scope of authority and the significant dissimilarities in the manner in which nurse practitioners carry out primary nursing in comparison to physicians (Fasoli, 2006). Moreover, education regarding those dissimilarities will probably lessen the desire of a lawyer and a patient forwarding a malpractice claim. Four, the opportunities for nurses should be enhanced to diffuse and lead collaborative enhancement attempts. Nursing associations, public and private funders, nursing education programs, and health care organizations should extend prospects for nurses to manage and lead. Conclusion The transformations that have taken place since 1960 have enabled primary nurse practitioners to play a significant role in the treatment and care of patients. Primary nursing has also inspired nurses to operate as drivers of change in the health care setting since the establishment of the nursing profession. In the present day, the expert purpose of nursing practitioners should incorporate demonstrating the input they can make to advancing health care. The ratio between nurse and patients has also been startling. Nevertheless, prominence of primary nursing is permanence of care for the higher autonomy and the patient and responsibility of practice for the primary nurse practitioner. In addition, primary nursing has been perceived as a system that upholds standards and assists junior staff permitting them to advance their managerial and leadership skills. Also, as the 21st century progresses, the nursing profession faces a number of challenges. Recurrent shortages of nurse practitioners continue to be experienced, and a durable answer to maintaining a sufficient supply of nurses is still subtle. As there is an aging in the baby boom generation, significant numbers of the elderly may stretch the health care system and demand enhanced amount of nursing care. The nursing field has constantly illustrated its capacity to adapt to varied and changing health care requirements. It remains a highly respected and an extremely admired profession that attracts numerous new applicants. There is minimal skepticism that nursing will continue to sustain its standing as an extremely significant profession (Fraser, Eades, Glackin & Holmes, 2002). References Boltz, M. (2011). Sit down for a minute: The healing power of relationship-based care [PDF]. Nurses Improving Care for Healthsystem Elders, A NICHE Showcase Interview. New York: Hartford Institute for Learning. Dobson, S. & Tranter, S. (2008). Organizing the work: Choosing the most effective way to deliver nursing care in a hospital haemodialysis unit. Renal Society Australia Journal, 4(2), 55-59. Fasoli, D. R. (2006). In context: Exploring the influence of nursing professional practice on organizational quality. New York: Free Press. Fellows of the American Academy of Nurse Practitioners. (2007, December 5). Nurse practitioners: Promoting access to coordinated primary care (Policy Brief). Retrieved from http://www.aanp.orglAANPCMS2 Fraser, N., Eades, J., Glackin, I., & Holmes, J. (2002). Palliative care nursing: building the foundations for primary nursing. Nursing Times, 98(41), 36-38. Friedberg, M. W., Hussey, P. S., & Schneider, E. C. (2010). Primary care: a critical review of the evidence on quality and costs of health care. Health Affairs, 29(5), 766-772. Hayman, B., Ciof?, J., & Wilkes, L. (2006). Redesign of the model of nursing practice in an acute care ward: nurses’ experiences. Collegian, 13(1), 31-36. Manthey, M. (2002). The practice of primary nursing: Relationship-based, resource-driven care delivery. New York: Macmillan Publishers. Weber, J. R., & Kelley, J. H. (2009). Health assessment in nursing. California: Sage Publishers. Read More