Nursing and Midwifery - Position of Knowledge, Competence, and Professional Performance - Essay Example

? Nursing and Midwifery Position of Knowledge, Competence and Professional Performance INTRODUCTION 1. Definition and Milieu The buzz word knowledge which refers to the set of ideas and instructions of the formulating aspects of life, along with competence which is the continuous struggle of human beings to serve more efficiently when applied into active formulation create practice; are like many other words in health care, but they are of more significance. These three words are of specified significant resonance as they are for the dream factory of the future of many health care specialists today. In accordance with many scholars’ knowledge, competence and performance are looked upon as a cycle. They believe that the first step for a health care individual is to gain knowledge throughout their existence and to affiliate with competence side by side. The previous two steps which are believed to be never ending are then accompanied by performance. Hence, this is a lengthy one for professionals as it is not just based on learning but also on its outcomes in the professional practice, which is why Eraut (2000: pp.234) has put forth that other than its effects on the evaluation regarding the outcomes of professional work, it also impacts its nature. 1.2. Validity of Knowledge, Competence and Practice in Nursing and Midwifery When health care professionals face a situation in which different sources of knowledge, the opportunity for competence, and the adequacy of performance are put forth for selection, such a process is extremely vital for them in structuring their future. The process of coming to a decision regarding the limitation of knowledge and goal achievement may either be commenced through logical verification or commonsensical conjectures. Where health care individuals are still not aware of how far they have come, in nursing however, knowledge, competence and performance are essential components that need to be focused on and verified. This process evaluates and affects the ability of midwives and nurses to prioritize medical intercessions, as they are provided with knowledge and assessment skills themselves on the basis of varying probabilities of their position. As the House of Commons Health Committee (2010: pp.12) verified that the understanding of goal achievement, let it be continuous or not, is always reflected by competence assessment tests. This specified combination of professional stance is a vital process in the field of nursing and midwives as it has been divided into sub-divisions of formulations that include the processes like gaining the philosophy, evaluating the theory, working on the methodology, and then implementing it into professional practice. This paper proposes to contribute to the quality of learning and implementing the practices of both nurses and midwives, and the clarification of many uncertain formulations. 2. CASE SCENARIO As per the verification that needs to be provided, the question that has cropped up is regarding the “goal achievement and knowledge achievement of nurses and midwives”. The formulation suggested by many scholars such as Manley (1997: pp.179-190) that knowledge can be continuously increased and articulated by nurses as they gain respect and can influence the health sector, but, it is the formulation of midwives that the process of goal achievement has ended for them as they have gained whatever knowledge or objective they were to grow. A range of indicators of knowledge, competence performance assessment, and pragmatic evidence regarding the effectiveness of both nurses and midwives in measuring these key elements show that the latter formulation provided by midwives is irrational. A key challenge that was identified in all articles reporting on such formulations and the performance assessment was ensuring objectivity. 2.2. Comparison and Contrast There is limited evidence about the verification of whether or not midwives should gain further knowledge for competence and professional practice. A large number of studies have focused on the competence and competence assessment, portfolios, and objective structured clinical examination (OSCE) of both the nurses as well as midwives. As far as peer assessment, direct observation, self-assessment, continuing education, and patient outcomes are concerned, it was found out that for nurses the job is more complicated as they have to confront patients on a much wider scale, whereas that for the midwives it is quite narrow as they need to confront a small scale of stances. Thus, this shows that for midwives the clarification that they have achieved their goal of gaining what has been presented, can be considered adequate. But when it comes to competence, even though initial competence with only limited investigation of issues regarding continuing learning was focused on by majority of articles, yet it was related that nurses and midwives work side by side on different levels. It has been suggested by a variety of scholars and researchers that the formulation of the thought that midwives have reached their goal while nurses could further learn is based on self-reflection of both the categories. This has been specified by Contino (2004: pp.52-64) that good nurses are made by a long lasting process of education and learning which is reflected by them in their professional practice. Contrary to the former thought, this verifies that for midwives it is necessary to never stop learning as they are linked to a very active part of the health care aspect. 2.3. Validation of Hypothesis Another indicating viewpoint with regard to the formulation of midwives that has been gained refers to the elucidation that a large number of problems can be seen in the midwifery performances due to the similar belief that they have achieved their goals and need no further learning, which has been believed through logical assessments that midwives need to dig deeper into the knowledge of their fields for solving these issues. Many indicators have been used to take account of such issues and it has been gained in accordance with Hunter (2001: pp. 440) that there are spaces left in between the midwifery practices. Hence, if midwives believe that they have reached their goals of learning and developing, they would be unable to fill in these gaps which need more knowledge and tutoring. Thus, as per the cycle mentioned above, it is shown in their practice with problems like lack of understanding between mothers and midwives, issues regarding intimacy, uncertainty in swift and hasty procedures, and lack of developmental strategies. Thus, one aspect is clear from the studies that identify that adequate preparation and knowledge with regard to competence for midwives is important. In order to contribute in the best way nurses can, it is necessary to have appropriate knowledge and transaction skills. In any specified zone of health care, the successful establishment of nurses is not possible if they are unable to make right clinical decisions, and/or if they lack judgment skill, which are only possible to gain through knowledge and the ability of competence. But the thought that nurses and midwives are both respected on the basis of their knowledge and conflicts with many thoughts presented by scholars, Bastable (2008: pp.5) believes that the role played by the nurses is that of a ‘caregiver’. Thus, the verification that nurses are respected and that they influence health care by their knowledge is not true, in fact they do so by successfully using whatever knowledge they have achieved so far through learning and competence in professional practice. Contrary to this, if midwives believe that they have gained all they needed, then it needs to be proved in their professional practice, which is currently not stably represented. This is why there is a need for the specification that midwifery shall not be labeled as a staged phase with limited goal instead more and more study and research is required as the stages commence. This is why Wilson and Pirrie (2000: pp.2) believe that midwives cannot cooperate in helping themselves and the patients because professional development is an outcome of continuous learning specifically in health care sectors and this verifies that without the help of continuous learning. It has been specified by a large number of scholars that no matter what the educational background level of midwives or nurses may be, it is not the academic performance that matters but the learning juncture that does, which is why when the aspect of competence between nurses and midwives is brought forth, it is not the level of professional background that matters but the amount of knowledge that is being implemented is counted. It has been considered by Hundley, et al (2008: pp. 80), that the point which needs to be put forth the nurses and midwives for clarification is that no matter how much of excellence is gained in the academic performance by midwives and nurses, there is always that slot of awareness and an educational path that is made available to them as they enter professional practice. Hence, just because it is a common formulation of midwives that they have reached their goal of influencing the health care sector and gaining whatever was available, it cannot be leveled with the idea that there is always a spot for the betterment and development; let them be nurses or midwives. If referred to the aspects to which nurses and midwives are brought forth, the American College of Nurse-Midwives (2011: n.pg) states that they range from biology, microbiology, chemistry, and human anatomy and physiology, social sciences, such as sociology, psychology, anthropology, and lifespan development to English, women’s studies, and a foreign language; it can be specified that no matter how much knowledge is gained, it can always be developed through competence and can be implemented in professional practice side by side through improvement. Nursing and midwifery have a long tradition of excellence in various countries such as the UK, USA and Europe, still many times nursing and midwifery are recognized as separate professions only due to the fact as Tilley and Wilson (2004: pp.8) believe that midwives themselves have cornered themselves as limited receivers of knowledge as they believe they have no more beans to spill. 3. ANALYSIS To some extent it has also been specified that the consideration of the fact that midwives believe they have influenced the health care system and have gained their goal as it can be seen that along with nurses, midwife practitioners have dual qualifications. They are also working on becoming skilled workers by following integrated theoretical and practical educational programs. A large number of programs that are being run by universities and higher education institutions (HEIs) are providing both nurses and midwives with opportunities to obtain excellence in various categories of professional practice. Along with this, in many studies, specifically that provided by Douglas (2011: pp.697) it has been stated that in health care settings and clinics, practical placements are being commenced in order to make sure that both nurses and midwives are provided with the opportunities of a competent environment for overcoming everyday challenges. The reason to ponder upon is that these opportunities are being provided to nurses and midwives so that they avail them and become an active part of the learning and development process. Also, they are provided these opportunities because they are asked for and considered by midwives and nurses. There are a wide range of post-qualification opportunities in clinical nursing, midwives, and nurse education and management. Therefore, as the statement provided by Manley itself suggests that the process of learning and development for the nurses shall remain never ending as they implement what they understand in their practice, this will bring them appreciation from their colleagues and the positivity of influencing the health care region. This does not imply the statement considered by midwives that they have adequately gained their goals and influenced the health care sector. This is for the sole reason that if nurses being on a much wider context of professional confrontation need more learning and assessment, then midwives should see this situation as a challenge even being in the zone of a narrow patient confrontation. This formulation needs to be tested by organizations as an issue of mounting and executing ample assessment strategies for nurses and midwives. Thus, this would refer to the idea that educational programs shall be introduced by organizations based on current experiences for assessing competence in pre-registration of nursing and post-registration of midwifery programs. 4. CONCLUSION It is a fact that rapid and far reaching changes have been made on the basis of initial educational necessities as per my personal assessment in the clinic between nurses and midwives, and on the demands made by professionals in their everyday work. Thus, it is necessary to understand that as time passes, more and more demands along with opportunities are provided to both nurses as well as midwives. Hence, in order to utilize these opportunities and fulfill these demands, in my perspective, it is important that nurses and midwives avoid any deviance from learning and development as they themselves believe in accordance to the findings. It is a fact that at every level of their profession midwives have to make decisions at national, local, and in face-to-face practice with clients, and that quality of educational processes and the delivery of care is affected by their decision, thus, as presented by McGraw-Hill (2008: n.pg) they need to make sure that further foal placement and achievement is carried out by learning and competence. Reference American College of Nurse-Midwives, 2012. Become a midwife. [Online] Available at: < http://www.mymidwife.org/Become-a-Midwife> Contino, D.S., 2004. Leadership competencies: Knowledge, skills, and aptitudes nurses need to lead organizations effectively. Critical Care Nurses, 24(3), pp. 52-64. Douglas, M.R., 2011. Opportunities and challenges facing the future global nursing and midwifery workforce. Journal of Nursing Management, 19(6), pp.695–699. Eraut, M., 2000. Developing professional knowledge and competence. Abingdon: Routledge. House of Commons health Committee, 2010. Annual accountability hearing with the Nursing and Midwifery Council. Scotland: TSO Hundley, V., et al., 2000. Raising research awareness among midwives and nurses: does it work? Journal of Advanced Nursing, 31(1), pp.78–88. Hunter, B., 2001. Emotion work in midwifery: A review of current knowledge. Journal of Advanced Nursing, 34(4), pp. 436–444. Manley, K., 1997. A Conceptual framework for advanced practice: An action research project operationalising, an advanced practitioner/consultant nurse role. Journal of Clinical Nursing, 6(3), pp. 179-190. McGraw-Hill, 2008. Essential calculation skills for nurses and midwives. Columbus: McGraw-Hill. Tilley, S. and Watson, R., 2004. Accountability in nursing and midwifery. Oxford: Wiley. Wilson, V. and Pirrie, A., 2000. Multidisciplinary team-working indicators of good practice. [Pdf] Available at: < http://moderntimesworkplace.com/good_reading/GRWhole/Multi-Disciplinary.Teamwork.pdf>. Read More