Nursing Education: Its Ramifications on Practice and the Impact on Healthcare Disparities - Research Paper Example

Nursing Education: Its ramifications on practice and the impact on health care disparities The need for improved educational programs in nursing has been accentuated in response to the rapidly changing health care environment. Educators today, feel an overwhelming need to design and offer enhanced and comprehensive healthcare programs in order to deal with the increased complexities and healthcare needs of patients. It is only through effective education, that, the growing needs and demands of patients can be met, successfully. An effectively designed educational curriculum plays an important role in enhancing the quality of life of people, and help in eliminating health care disparities witnessed in various forms across various sections. This paper on Nursing Education, aims to discuss various issues related to various aspects of nursing education; the implications of nursing education on practice as well as its role in addressing healthcare disparities. Contents: Sr.# Topic Pg. # 1. Introduction 3 2. Background 4 3. Literature review 4. Discussion 5. Conclusion References 12 1. Introduction “Nursing education is very people-intensive. You cant just put one more chair in the classroom” Carolyn Williams, 2010 Health care organizations, in recent times, have taken giant strides towards development in terms of both: technological advances as well as theory, ultimately leading to significant transformations in the manner in which nursing education is pursued and implemented. Some such significant changes include – the revolutionary technological developments in the field of healthcare; increase in consumer awareness; rise in demand for improved healthcare services; pressure to control and reduce costs; increase in complexities of aged-care service provision etc. Such changing demands are in turn met by nurses, who often face social, moral and ethical dilemmas largely arising from their daily practices. Furthermore, several major changes are predicted in the near future, for instance: a substantial rise in life-span of individuals owing to technological developments as well as advances in medical science. Any rise in the average life-span of individuals hint at a subsequent expansion of aged population, who in turn may require critical healthcare services. Nursing education can help the nurses in dealing with and adapting to such changes effectively and hence can be considered as an inevitable tool in improving the quality of life of individuals. In order for nurses to become fully equipped and capable of providing highly sophisticated care to patients in need of critical care; they need to become highly skilled in aspects such as – critical thinking; excel in the art of evidence based practice; and improved reasoning abilities (Oerman et al, 2000). Today, nurses are required to use sophisticated technological aids to improve the quality of life of patients. Such use of technology requires effective training. They are often required to provide highly skilled services in remote areas or unfamiliar surroundings. Such complex demands of their profession warrant proper education and training for the nurses which may enable them to function effectively, safely and competently by using innovative methods. This in turn, requires critical thinking on the part of the nurses, which is acquired through formal education. According to Oermann (2008) the concept of critical thinking in nursing refers to the provision of effective, appropriate and safe methods of care to patients in a wide variety of settings. 2. Background The need to transform nursing education is increasingly gaining widespread recognition and support. Information on healthcare is gaining greater significance than ever before and the need for increased knowledge is growing exponentially thereby creating the need for comprehensive nursing curricula which addresses the challenges faced in the contemporary nursing practice. Nursing education equips the nurses to adapt to the changing environment effortlessly and effectively implement technology. Nursing education today must aim to not only offer courses which enables their students to improve their efficiency in everyday practice; but also equip them to assume greater roles such as those of - innovators, collaborators as well as critical thinkers. The nurse educators in present times carry an additional responsibility – that of preparing the students to effectively adapt to the ever changing environment, which compels them to cater to the changing demands and expectations of their patients and practice efficiently. As the healthcare needs continue to escalate, and the complexities begin to rise, it is only through an effective and well-designed education curriculum that, the nurses can cater to the ever changing needs and demands of the patients. Nursing education can help in enhancing the practice, eliminate or reduce healthcare disparities and improve the quality of life of the citizens. The same is discussed at length in the following sections. 3. Literature Review This literature review discusses the various aspects associated with nursing education such as – evidence based education / healthcare; critical thinking; innovation in education and its ramifications on practice. In view of the ever changing external environment, with increased number of chronically ill patients in need of critical healthcare services, the role of nurses, in general, is continuously challenged (Alexy & Elnitsky, 1996; Moneyham & Scott, 1997; Jeglin-Stoddard & DeNatale, 1999; Marek & Rantz, 2000). They are required to offer effective care in unfamiliar and often highly complex situations and environments and display adequate levels of problem solving skills and ability to manage tricky situations through reasoning and analytical skills. Such skills require proper training, which can only be acquired through formal education. As a result, the conventional roles played by nurses – that of mere healthcare service providers have radically been transformed to include complex decision making skills and ability to deal with unforeseen situations effectively and in an appropriate manner. Their skills also include proper utilization of resources and ability to control or reduce costs. The role of conventional nurses in the past, has thus widened dramatically and is replaced by a specialized and highly skilled staff. Such transformations indicate the changing face of modern healthcare and highlight the significance of nursing education to deal with contemporary challenges. Some such significant facets of nursing education with far reaching implications on practice are discussed below: 3.1. Evidence based education / health-care According to Emerson (2007) the term Evidence based nursing education “involves the use of best evidence to justify particular teaching or curricular interventions, considering the needs of individual learners, the professional judgment of nurse educators, and the resource costs of the interventions" (Pp. 309). It also entails the application of conventional skills of nursing education; a reasonable understanding of the patient’s health so as to enable themselves effectively diagnose, interpret, and apply appropriate methods based on their knowledge gained through education and finally evaluate the patient’s overall health needs. Due to rapid technological developments there is an overload of information which is easily accessible to nurses. This has led to an increase in expectations from the nurses to provide up to date and effective health care services by incorporating such evidence-based knowledge in their daily practice. According to Malloch & OGrady (2009): "Evidence -based practice is the integration of best research evidence with clinical expertise and patient values”. (Pp. 59) Today nurses have the ability to provide high quality care to their patients by accessing research-based clinical information which provides guidance for clinical practice. Such information is easily accessible and available on various mediums such as research publications, medical journals as well as online sources. The same can be effectively used by nurses in improving the healthcare services offered to the patients and thus the overall quality of life of the patients. 3.2. Critical thinking: There is a direct relationship between the concept of critical thinking and the complexity of the contemporary healthcare environment which in turn is marked by rapidly changing technology and consumer demands. In such a dynamic environment, healthcare providers are required to acquire, use and implement multiple forms of knowledge in order to achieve effective decision making. This requires critical thinking abilities on the part of the nurses, along with other critical skills such as good analytical and reasoning ability and effective decision making (Oermann, 2007). According to McDonald (2007): “Critical thinking in nursing is an essential component of professional accountability and quality nursing care. Critical thinkers in nursing exhibit these habits of the mind: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open mindedness, perseverance, and reflection. Critical thinkers in nursing practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge” (Pp. 51). In the contemporary healthcare field, nurses are continuously exposed to an awful lot of information and data which they are required to sort, analyze and adapt for problem-solving and other similar issues which help them in taking effective decisions. Nurses are required to make fast and effective decisions in their everyday practice which needs critical thinking. Adopting and integrating such aspects in nursing education helps in enhancing their knowledge and sharpen their skills thus leading to provision of good quality care to the consumers. 3.3. Innovations in nursing education: 4. Discussion This discussion is based on the issue of healthcare disparities and the manner in which nursing education can bridge the divide. The disparities in healthcare are mostly related to adult / aged health care, and availability of healthcare services among ethnic minorities. The disparities in health care; is both geographic as well as race-specific in nature. According to the reports available from the American Medical Association (AMA, 2010): 31 percent of minority adults, ages 18-64, do not have insurance, compared with 14 percent of white adults in the same age group; 29 percent of minorities said they have little or no choice about where to get health care, compared to 16 percent of whites; Minority adults report more problems with receiving care. 40 percent say they have "a major problem with having to pay too much for care," compared to 26 percent of whites; 18 percent of minorities said they have difficulty obtaining specialty care, compared to 8 percent of whites; 21 percent of minority adults have problems with language differences in receiving care, with about one quarter of those who do not speak English as a first language needing an interpreter when seeking health care services; When asked about quality of life, 36 percent of minorities report "high" stress levels, compared to 26 percent of whites. Health care disparities in provision of services to aged / elderly patients: There is a severe imbalance between the health care needs of older adults and the availability of educated nurses - who are trained and qualified enough to cater to their highly critical needs. The imbalance between health care needs of older adults and the availability of nurses educated to work with them is specifically acute in rural areas. Also, the nurses often lack adequate skills and training required to deal with complicated cases associated with “elderly care” and such services are often not easily accessible. Thus the nursing education programs need to accommodate age-specific courses designed to offer specialized care to the aged population. Health care disparities among ethnic minorities: According to available literature the health of minority populations in the U.S. including African Americans, Hispanic Americans and American Indians was far worse than that of the white population (Office of Minority Health, 2010). Such disparities in health care can be overcome by providing culturally inclusive nursing education programs. The students from ethnic minorities must be encouraged to participate and enroll in nursing courses which are aimed at providing services to their communities. This will help in overcoming language barriers and include this socially excluded section in the provision of healthcare facilities. Conclusion In conclusion, nursing education can play an important role in bringing about significant transformations in the field of healthcare, and help in eliminating disparities in services across various segments. Continuing educational workshops and other materials can be effectively used to ensure that the nurses are well-trained to deal with any given situation, and equipped to offer high quality services regardless of the familiarity of the environment. Also, encouraging the racially ethnic minorities to participate and enroll in nursing programs, will help in overcoming language and cultural barriers and bridge the divide between healthcare services provided to them and to the general population. Nursing education can hence be regarded as a means and end to the provision of modern health care facilities. References: Secondary Sources: Alexy, B. B., & Elnitsky, C. (1996). Community Outreach: Rural Mobile Health Unit JONA 26 (12): Pp. 38-42 Emerson, R. J., (2007). Nursing education in the clinical setting, Elseiver Health Sciences Publication Jeglin-Stodard, A. M., & DeNatale, M. L. (1999). The Challenge of Change with Creative Collaboration. Nursing & Health Care Perspectives 20(4): PP.186-193. Malloch, K., O-Grady, T. P., (2009). Introduction to evidence-based practice in nursing and healthcare, Jones & Bartlett Publication, Pp. 55 - 60 Marek, K. D., Rantz, M. J. (2000). Aging in Place: A New Model for Long-Term Care. Nursing Administration Quarterly 24 (3): Pp. 1-11 McDonald, M., (2007). The nurse educators guide to assessing learning outcomes, Jones & Bartlett Publication Moneyham, L., Scott, C. B. (1997) A Model Emerges for the Community-Based Nurse Care Management of Older Adults. N & C Perspectives on Community 18 (2): Pp. 68-71. Oermann, M. H., (2007). Annual review of nursing education: Clinical nursing education, Springer publication, Pp. 226 Oermann, M. H., (2006). Annual review of nursing education: Challenges and new directions in nursing, Springer Publication, Pp. 205 - 212 Oermann M, Truesdell S, Ziolkowski L., (2000) Strategy to assess, develop, and evaluate critical thinking. Journal of continuing Education in Nursing; 31(4) Pp. 155-160. Primary Sources: AMA (2010). Report on racial and ethnic disparities in health care. Accesed: December 1, 2010 from: The Office of Minority Health (2010). U.S. Department of Health and Human Services, Accessed: December 1, 2010 from: Williams, C., (2010). Carolyn Williams quotes [online] Accessed: December 1, 2010 from: Read More