Nursing-Art and Science - Essay Example

of the of the Concerned Nursing 24 April Nursing-Art and Science In the context of the strengthening of nationalhealth systems and doing away with the healthcare inequities, the health care systems the world over simply cannot do without taking into consideration the crucial role played by the nursing profession in the gargantuan task of achieving the internationally envisaged health care targets, bolstering the national health care systems, and enhancing the access of the common masses to the health care facilities and services (WHO 2011). According a formal recognition to the role played by the nurses in the international and national health care systems and facilities is bound to facilitate a better and improved cooperation and communication amongst the varied human elements of health care, impressively bettering the standards of patient care, a systematic accumulation of data on the part of the nursing professionals to assure a better evaluation of the end results of nursing care, a greater adherence on the part of the nursing professionals to the agreed upon standards of nursing care and a realistic and satisfactory assessment of nursing care, thereby pragmatically and positively impacting the overall visibility of nursing at a national and global level (who 2006). A formal recognition of the contribution of the achievements and contributions of the nurses in the running and management of health care facilities and institutions will not only boost the morale of the nursing professionals, but could also be positively be expected to address the problem of a severe shortage of qualified and skilled nurses across the developed world. Recognition of the difference made by the nursing professionals in the cause of health care will accord a salubrious visibility to the nursing profession, thereby encouraging and stimulating the potential candidates to affiliate to the cause of health care and service. A formal recognition of the contribution of the nursing professionals in the health care systems is a subject that is not merely confined to verbal declarations and speeches, but is rather something that solicits a practical implementation and actions in the varied aspects of health care. It calls for a commitment on the part of national and international health care bodies and institutions towards the training and retention of nursing professionals, helping them develop the appropriate skill mix and abilities, applicable at all levels, be it at the level of primary health care or at state of the art, high speciality institutions (WHO 2011). This calls for the extension of incentives to the nursing professionals at all levels, are they rural, sub-urban or urban. Nursing professionals not only extend a practical contribution in the accomplishment of normal health care and procedures, but also happen to be salient contributors to health research (WHO 2011). The need of the hour is recognizing the multidisciplinary contribution of nursing professionals in state of the art research, thereby according a significant contribution to the health care services within the ambit of scientific evidence and knowledge (WHO 2011). There is no denying the fact that it is the nurses that constitute the majority segment in the work force deployed in the health care systems around the world. Still, it goes without saying that the practical recognition given to the nurses by the planning, implementation and monitoring bodies within the health care systems is not in proportion to their actual numerical strength. The international and local bodies need to address this lacuna by envisaging targeted action plans aimed at developing the standards of nursing education and training (WHO 2006). The health authorities do need to extend the long due recognition to the role played by the nurses in the interdisciplinary teams designed to address the health issues and challenges facing the health care systems. The health care systems and bodies need to strike a practical collaboration with the nursing professionals and bodies to consolidate the national and sub national statutory and legal mechanisms that govern the nursing profession and practices (WHO 2006). In personal context I believe that considering the high stress nature of the nursing profession, the number of young individuals interested in joining the nursing services has gradually been dwindling over the years (Nwabuzar 2007, p. 1). However, this potential shrinking of the pool of nursing professionals could also be attributed to the minimal recognition awarded to the contribution and role of nurses in the health care, thereby negatively impacting the visibility of nursing (Nwabuzar 2007). It is high time that the health care systems in the developed world extend the long due recognition to the experience and skills of nursing professionals. Not only will it bolster the visibility of nursing but will also allow the health care administrators, researchers and institutions to harness the experience and expertise of nurses, thereby allowing them to alleviate the standards of health care and allowing for the influx of propitious innovations in the realm of healthcare. Hence, in a practical sense, one single issue that if redressed could make an immense contribution to the visibility of nursing is the extension of a formal recognition to nursing, as an important stakeholder in all the aspects of health care. 2. There is no denying the fact that nurses ought to have a narrative understanding of the respective patients to facilitate the task of extending good nursing care. It goes without saying that in a pragmatic context, there sometimes is a wide gap between ethical and clinical decision making, which gives way to immense problem in applying the crux of population oriented statistics to the respective individual patients (Edwards 2001). Hence, in the case of the nurses, so as to be an effective clinician, it is pivotal to develop an understanding of what is good for a particular patient in a particular situation. In such scenarios it becomes imperative to facilitate a narrative understanding of a patient’s situation and circumstances. In the realm of nursing and medical interventions, any particular patient never prefers to envisage one’s life as a mere statistical figure. Each and every patient considers one’s life to be unique and is immensely interested in the chances one has. While making clinical decisions, the nurses are required to contend with the ethical repercussions associated with decisions taken in a particular situation (Brown 2000). Hence the nurses are required to strike a professional, but human bond with a patient so as to take decisions which extend the maximum benefit to a patient while doing a minimal of harm. The conclusions driven from the scientific objective research happen to segregate the social and the clinical (Edwards 2001). However, nurses while contending with the actual clinical situations do come across scenarios where they cannot stringently segregate the social from the clinical (Edwards 2001). For instance a nurse may come across a patient who is 95 years old and hence by the dint of scientific expectations may be deemed to be open to varied medical problems and issues. However, while developing a narrative understanding of such a patient, the patient may give and account of oneself to the nurse as per which one is fit and exceptionally healthy. In contrast, a nurse may many a times come across patients in their early 30s, who may require the nurse to customize their medical treatment in consonance with their frail and fragile health. Thus, under such circumstances, the conclusions drawn by a nurse on the basis of scientific expectations may fail to rhyme with the actual narrative understanding associated with a patient (Brown 2000). Under such situations, the social circumstances of a patient weigh in heavily on the diagnosis and commensurate clinical interventions, and the adjustments made by the doctors and nurses may eventually prove that the patient happened to be right (Brown 2000). A narrative based understanding of the patient allows the nurse to accomplish the Evidence Based Practice at their best, especially more so in scenarios where the scientific research suggests one course of treatment and clinical intervention, while on the contrary the choices and decisions made by a nurse are predominantly guided by the patient’s concerns and the realistic estimates arrived at on the basis of the narrative understanding facilitated with the patient (Brown 2000). Hence, in the case of astute and experienced nurses, good clinical judgement is not merely guided by the scientific notions of good practice, but is also coloured to a large extent by the relationships and bonds struck with the patients. This helps the experienced nurses exploit their seasoned clinical judgement to evaluate and understand the practical medical feasibility of a patient’s chosen and preferred decisions, and design a course of treatment that tends to minimize the risks associated with the patient’s preferred decisions (Edwards 2001). To facilitate a proficient Evidence Based Practice, it is vital to take into consideration the salient concerns highlighted by the patient, the information and history associated with any specific patient, the preferences acceptable to a patient, and the values and norms sacrosanct to a patient (Brown 2000). Experienced nursing teachers always make it a point to encourage their students to always try to weave the narrative understanding developed pertaining to a particular patient with all the accompanying emotional and social facts and concerns with the appropriate and proven historical clinical facts associated with that case. The imperative to strike a good clinical judgement necessitates a good and thorough understanding of a patient and a timely progressive reasoning that takes into consideration the changes occurring in a patient’s condition (Brown 2000). It is too naive to assume that the evidence garnered from a clinical trial will fit the situation of any patient irrespective of one’s personal beliefs and concerns. Hence it is a must for a nurse to develop a narrative understanding of a patient so as to extend a realistic touch to one’s practice patterns and clinical results and understanding. 3. With the ongoing burden of extending a quality health care to a diverse population and the concomitant resource crunch, the health care systems around the world are under immense pressure to make the best use of available monetary and human resources (Scott, Matthews & Corbally 2003). There is no denying the fact that the nursing professionals constitute the single largest group amidst the assortment of health care professionals constituting the health care systems in the developed world (Scott, Matthews & Corbally 2003). Hence the nursing professionals could positively be expected to play a pivotal role in the refurbishment and restructuring of health care systems around the world. Therefore, the timely and optimal, pragmatic empowerment of nurses will certainly encourage them to come out with innovative practices that will bolster the health care system and will add to the quality of nursing care (Scott, Matthews & Corbally 2003). The primary challenge before the contemporary health administrators and managers is to harness the skills and expertise of the nursing professionals and to sufficiently empower them to facilitate a positive attitude, so as to make a meaningful difference to the quality of health care (Centre for the Development of Nursing Policy and Practice 2003). In a health care scenario there may be many factors that may impede the thrust and scope of nurse empowerment. Poor management style is one single factor that may not only entrench the sense of inertia and powerlessness ingrained amidst the nursing professionals in an organization, but may also give way to circumstances that may desist the nursing professionals from taking initiatives, as and when required (Scott, Matthews & Corbally 2003). Poor management styles mostly turn out to be centralized in their nature and scope and tend to scuttle initiative and delegation at all levels in a health care organization, which also includes the nursing professionals. They sabotage the growth of horizontal and vertical channels of communication within the institutions and organizations, thereby constituting the single most potent impediment to informed decision making. This makes the nursing professionals dependant on the advice and direction of the specialists and superiors, even when they have the expertise and the wherewithal to take a timely decision and make an apt clinical intervention. Managers and administrators with faulty management styles give way to needless, counterproductive and unwarranted politics and power tussles in the health care institutions that severely comprise initiative and quality of health care. As in all professions, nurses tend to learn a lot from their actual experience and do tend to develop skills and expertise by the dint of practice and observation. Hence, recourse to delegating ground level decisions to nurses could relieve the doctors and other specialists from routine and simple procedures. However, a nursing professional simply cannot afford to or say dare to take initiative in matters of clinical decision making, unless one has the confidence that one enjoys the support, trust and confidence of the management (Scott, Matthews & Corbally 2003). Thus, in the contemporary overstressed health care systems, the health care organizations and institutions simply cannot dare to be effective and sufficient without empowering their nursing professionals. However, it goes without saying that such empowerment should not be merely based on the needs and resource constraints, but must also be backed by opportunities for skill enhancement and experience accumulation. It is a must to mention that the nursing education institutions could play a major contribution to the cause of nurse empowerment (Scott, Matthews & Corbally 2003). Appropriate education and training arms the nursing professionals with the requisite confidence and willingness to grasp power, as and when it comes their way. It is also necessary for the health care administrators, managers, technicians and doctors to encourage the nurses to accept responsibilities tagged to specialized skills and expertise and to encourage and recognize them when they dare to stretch the limits of their skills and expertise. Eventually empowerment is a concept that relies for its sustenance on varied individual and environmental factors. Reference List Centre for the Development of New Policy and Practice University of Leeds 2003, Empowerment Narratives, Department of Health and Children, Dublin, viewed 24 April 2012, . Brown, Phil 2000, Perspectives in Medical Sociology, Waveland Pr Inc, New York. Edwards, Steven D 2001, Philosophy of Nursing, Palgrave MD, London. Nwabuzar, Ozo M 2007, ‘Legislative: Shortage of Nurses the School Nursing Experience’, Journal of Issues in Nursing, Vo. 12, no. 2, pp. 1-2. Scott, Anne P, Matthews, Anne & Corbally, Melissa 2003, ‘Nurses and Midwives’ Understanding and Experiences of Empowerment in Ireland, Department of Health and Children, Dublin, viewed 24 April 2012, . World Health Organization (WHO) 2006, Strengthening Nursing and Midwifery, Fifty- Ninth World Health Assembly, World Health Organization, Geneva. World Health Organization (WHO) 2011, Strengthening Nursing and Midwifery, Sixty- Fourth World Health Assembly, World Health Organization, Geneva. Read More