Article in Nursing in Hong Kong Annotation - Essay Example

Annotation of one of the Prescribed Journal Articles The significance of nursing and nurses is highly increasing all over the world and there are several vital issues faced by nurses in different parts of the world. In an important article, “Nursing in Hong Kong: Issues and Challenges”, David R. Thompson, the Professor of Nursing and Director in the Nethersole School of Nursing, Chinese University of Hong Kong, discusses the major issues and challenges faced by nurses and nursing in Hong Kong. The issues of discussion in the article are central to the profession of nursing, at least in this particular part of the world. Introducing the role of nurses in the special administrative region in Hong Kong, the author focuses on workforce, educational and practice issues, as well as on leadership in nursing. In a significant conclusion to the article, David R. Thompson suggests that there should be an effective strategic plan to determine sufficient numbers of properly educated nurses in Hong Kong. In this article analysis paper, the focus has been a reflective analysis of the arguments made by Thompson in his article determining the central arguments and assessing the validity of the essential points. In the introductory section of the article, Thompson focuses on the vital the role of nurses in the special administrative region (SAR) in Hong Kong and the author is emphatic about the importance of nursing to health and healthcare developments in the region. Thus, he explains the importance of nursing with regard to direct care, care coordination, health promotion, and health education. The nurses of the region deal with these essential functions in hospitals as well as community. “Nurses and nursing are central to health and healthcare developments taking place in Hong Kong, not the least because nurses comprise around 40% of the healthcare workforce. Nurses play a key role in the provision of direct care, care coordination, health promotion, and health education, both in hospitals and in the community. Quality and safety, driven by quality improvement programs and the promotion of evidence-based practice, have been two features that are central to nursing and healthcare.” (Thompson 2006, P 158). Therefore, according to the author, educational preparation and continuing professional development of nurses are of vital importance in Hong Kong. Resembling any other countries, nursing is experiencing several significant challenges in Hong Kong and the author broadly classifies those under four themes. These significant challenges confronting nursing in Hong Kong are workforce issues, educational issues, practice issues, and leadership in nursing issues. In the next section of the article, Workforce Issues, the author deals with the significant issues associated with employees in Hong Kong. According to him, healthcare system in the region has experienced major changes and these changes are especially with regard to the service organization and provision in an effort to improve clinical efficiency, accountability, and team work. However, these changes had a significant influence on the restructuring of nursing work which resulted in the growth of new roles for nurses in the region. These changes reflect in the nature and processes of nursing and the need for a nursing workforce which can improve health outcomes for patients. The article provides some illumining statistics concerning nurses in Hong Kong and there currently more than 34,000 nurses with certificates to practice in Hong Kong. The fifty five percent of these nurse work for the HA, while about twenty percent of them work either in the private sector or for the Department of Health. Though g Kong had a stable nursing workforce with no shortage until recently, there is an acute shortage of nurses in the region now According to the author, it is essential to adopt a new strategic approach to address the nursing shortage. However, there are essential challenges in the recruiting of nurses caused by those with vested interests and they want to employ nurses who can undergo 2-year apprenticeship training and receive lower pay. “The recruitment and retention crisis means that nursing is currently experiencing a shortage of experienced nurses and, although widespread, there is a critical shortage in some specialist areas including aged care and mental health. This has a deleterious effect on morale and the quality of the work environment, including quality of care. Because of job dissatisfaction, the loyalty and commitment of previously satisfied and highly regarded employees is being sorely tested. Thus, the long-term consequences will probably be difficult to judge and remedy.” (Thompson 2006, P 159). The author points out that it is important to design and provide a favourable environment to nurses for the purposes of professional and career development. In the next section of the article, Thompson discusses the educational issues concerning nurses and nursing in Hong Kong. There has been government policy objective in Hong Kong to improve basic nursing education to degree level with the intention of developing the quality of healthcare services. Therefore, there are a number of educational concerns in the region. “The government advises that a long-term requirement for bachelor-level nurses will be about 600 per annum. It is unclear how and by whom this number was determined. The problem is that there is no strategic approach to policy and hence no workforce forecasting and planning. Thus the number and type of nurses needed, the areas of need, and short-and long-term requirements have not been addressed.” (Thompson 2006, P 159). The author also deals with other significant educational issues including the rivalry between the universities and schools. He also maintains that the attempts by the schools to work together in order to avoid duplication also raise important issues. It is a challenge to design innovative, flexible programs that can address issues such as aging, community and primary care, and emerging and re-emerging infections and diseases. It is also important to meet the demands of issues concerned with practice and universities and nursing schools are often criticized for being too theoretical with too little emphasis on practice issues or the needs. Thompson, then, goes on to discuss the major practice issues concerning nursing and nurses in Hong Kong. Generally, clinical practice has been regarded as the most important element of nursing which involves the adoption of nursing standards, clinical guidelines, protocols, audits and benchmarking etc. However, in Hong Kong, these developments are not given great importance. “The patterns of service organization and delivery of care have often been imposed on nurses as a result of funding cuts or other catalysts for change. However, regardless of the drivers for change, new nursing roles have certainly emerged and evolved, which have changed from a functional to a holistic focus and from a task to a person-focused orientation. Nurses have gradually received greater recognition for their professional autonomy and expertise. The establishment of nurse specialist and advanced practice nurse positions within the career structure of nursing reflects the organizational acceptance of the new roles and responsibilities of nurses.” (Thompson 2006, P 160). The role nurse specialist was created to reflect the importance of clinical competency in nursing and there are 190 nurse specialists in practice today. However, the roles of these specialists differ among hospitals and departments and there have been debates on role differentiation, responsibility, accountability, and authority. In a new development, advanced practice nurse (APN) was introduced as a new grade in 2002 which permits the hospitals to promote the most experienced nurses to a senior position without delegating patient care to less experienced colleagues. Though it has been widely welcomed, the effectiveness of this grade has not yet been determined. In another major programme, the HA has started to support for the development of nurse-led interventions that have contributed to the care provided for patients and their families. “Although these new roles have been generally welcomed, the plethora of titles and functions highlight the need to conceptualize and clarify the boundaries and scope of practice. It would have been useful, in hindsight, to introduce some of these roles on a limited scale and pilot test their acceptability, feasibility, effectiveness, and cost-effectiveness.” (Thompson 2006, P 161). The major issues determining the development of advanced nursing practice have been identified in some important studies conducted and the author classifies them mainly into four. “These are the definition of (a) advanced nursing practice and the level of autonomy available, (b) skill mix and the implications of this to developments in practice, (c) the perceptions of individual nurses and their contribution to practice, and (d) patients’ expectations of care.” (Thompson 2006, P 161). The article also deals with some important leadership issues concerning nursing in Hong Kong and Thompson argues that there is essential need for strong visible leadership in order to ensure that nurses and nursing are represented at the high table. Although one may find significant nursing leadership by the HA, the Department of Health, and the three universities, there is a need for united and coherent leadership in nursing. “Thus, there is a need to form a strong alliance in order to give a common voice to nursing. This has been retarded to some extent because of the plethora of societies and organizations claiming to represent the interests of various nursing constituencies—education, practice, research, and management. There have been tensions and rivalries which have not served the best interests of the members of the profession as a whole.” (Thompson 2006, P 161). In conclusion, the author of the article maintains that the region requires a strategic plan to determine adequate numbers of properly educated nurses. “The people of Hong Kong deserve the best quality nurses and nursing care and this will only be achieved when sufficient numbers are properly educated. It is critical to ensure that university schools of nursing produce nurses who are responsive, flexible, knowledgeable, and competent. They must be able to work collaboratively in multidisciplinary teams in order to function effectively in the new healthcare era.” Therefore, he proposes association of all key stakeholders of nursing in the region, including the government, the universities, the HA, the Department of Health, and the private sector in order to produce high quality nurses for the new century. Such quality nurses can serve the people of Hong Kong in the best way and it is the main motivation of the article too. Bibliography Thompson, David R. (2006). “Nursing in Hong Kong: Issues and Challenges.” Nursing Science Quarterly, 19 (2). P. 158-162. Read More