Nursing Practice Guidelines and Theory - Research Paper Example

Running Head: NURSING Nursing Nursing Practice Guidelines Practice guidelines are scientifically proven reports that help doctors, nurses, carers and patients in coming to a decision regarding specific type of health care for a particular clinical circumstances. (McKinley, Parmer, Saint-Amand & Darbin, 2006, 57) Qualities of effective practice guidelines are Validity Reliability Reproducibility clinical applicability clinical flexibility clarity multidisciplinary process review of evidence documentation However, it is of vital importance to understand that these guidelines do not all the time account for individual dissimilarity among patients. Their purpose is not to replace doctor’s opinion with respect to particular patients or any particular clinical condition. (Navahandi & Aranda, 2006, 180) Educational Theory of Nursing The body of information which is being utilized to explain or elaborate several features of nursing profession is called Nursing Theory. (Warner, E. (2005, 250) Kinds of Nursing Theories Grand Nursing Theories Grand nursing theories possess the vast scope and propose broader concepts and suggestions. Such type of theories reveal and provide insights valuable for hospitals but are not intended for experimental testing. (Navahandi, 2006, 180) This minimises the chances of application of grand nursing theories for designing, demonstrating, and foreseeing nursing in some situations. Such type of theories are utilized for almost all levels of nursing. Mid-range nursing theories Middle-range nursing theories are not vast unlike grand nursing theories in scope and propose a valuable connection between nursing practice and grand nursing theories. Such theories present concepts and propositions at an inferior level of generalization and possess great scope for high trend of theory-based investigation and nursing practice strategies. (Warhurst, Grugulis and Keep, 2007) Nursing practice theories Nursing practice theories possess the narrowest scope and level of generalization and are designed to be utilized for only limited variety of nursing situations. Nursing practice theories offer frameworks for nursing intrusions, and foresee results and the effects of nursing practice. (Stelzer, 2008, 25) In the last 15 years, nursing in the United Kingdom have increased its reliance on skilled work groups or teams. Although the initial motivation for adoption of work groups and teams may be linked to well-publicised examples in other parts of the world, reports of many successful implementations in the United Kingdom have further spurred their adoption (Navahandi & Aranda, 2006, 160). The continuing importance in the practice environment was advanced by Jerry Junkins, CEO of Texas Instruments: "No matter what your business, these teams are the wave of the future" (Dumaine, 2008, p. 220). In old times, nursing used to be simple and nurses were expected to follow basic job description and perform duties accordingly. However, now a days nursing is considered as a whole package that needs from a nurse to possess number of skills besides having basic knowledge of their job. Unlike past, in the current scenario, whether the popularity of just knowing basics across U.K. practice environment will remain at high level is unclear. However, basic interpersonal and work skills of nurses are getting more popularity than the past. (Hiam, A.W. and Olander, K.W, 2007) The ability to function effectively within practice is becoming more critical to the success of new comers. The impact of globalisation can be seen everywhere allover the world. Nations changed their ways of doing politics, handling economy, military and cultural issues as an outcome of globalisation. Same is the case for nursing. In this paper, efficacy of educational theory and professional guidelines in the practice environment will be discussed. It will compare the modern day change in the complete outlook of nursing industry in pratice environment with the previous years and evaluate what and how exactly things have been changing in recent years. (Dollinger, 2005) Until recently, with the adoption of its "mission-based accreditation," curriculum standards have promoted a broad array of core courses in a content-oriented programme. A potential problem with this focus on providing all of the necessary content courses (nursing, economics, finance, information systems, management, marketing, etc.) is the failure to recognise the value of process in improving skills for the workplace. The development of important job skills may have been hindered by the concentration on cognitive knowledge. (Bellandi, 2004) In old times, manual skills were given more concentration to be more efficient employee. It used to include basic paper work, manual record keeping of patient’s history, filing, answering telephone calls etc. However, in current times it is more important to have atleast basic knowledge of Technical skills, even for nursing profession. These skills are used in a particular subject, art, or craft, or its techniques (Concise Oxford English Dictionary, 2004:1478). Technical skills are unique to each venture or field of specialisation (Timmons, 2007, 230) and entail "the ability to apply specific knowledge, techniques and resources successfully in the execution of an assignment" (Marx et al., 1998: 356). Thorough technical knowledge of nursing practices is thus required for success in modern day practice environment. These skills include, know how to operate Desktop computer for record keeping, fax machines as mode of communication, laptops, answering machines etc. Technical skills alone, however, are not sufficient to ensure reliability. Unlike past, it is also of crucial importance to know inter alia, marketing and financial management skills in modern day environment. Generally speaking, now days an efficient marketing work is considered as a key to success, in addition to technical skills. In 21st century, business is more than expertise in a field. Competition amongst businesses is also increased due to advancement of media and easily accessibility of variety of communication means. Hence, businesses require more focus on the customer demands (Shuman, 1999). Not just specific skills, but generic competencies are increasingly required, because of technological development and changes in the practice environment. In other words, not only skills to perform particular tasks are required, but also new skills and techniques to cope with changes in patient's needs (Godsell, 1992:26). Technical knowledge is thus required for nurses but more than that is needed in order to improve over all impact of a pratice. One amongst most demanding skill for present day practices is to improve Soft Skills. Such skills were hardly given any consideration in the past. Soft skills are interpersonal skills that characteristically incorporate social refinements, leadership improvement, problem solving skills etc. Soft skills are the most modern addition to nursing requirements for prospective nurses. (Conrad, C. and Poole, M.S. 2002) Soft skills are now taught as a separate subject in nursing schools. Orelse, one may attend lectures from motivational speakers. Most of these skills become part of one’s personality attributes, for instance, good behaviour or optimistic approach towards work ethics. Some other examples may include to remain positive even in a critical situation. There are people, who face difficulty in behaving against their norm. It is soft skill to smile nicely when a nurse sees a patient. (Frese, M., Van Gelderen, M. and Ombach, M. 2006) Such skills are specially helpful in case of patients with severe illnesses. In period of recession, when lots of individuals lost their employment or they are anticipating of a job loss, it would be a good idea to make a new resume and improve soft skills together with the work skills that all pratices are in search of, specially those in cancer care. Good Communication skills were not as necessary in the past as today for adult nursing staff. There are a variety of definitions of the term "communication". According to Erasmus-Kritzinger, Bowler, and Goliath (2001: 3) "Communication can be defined as a two-way process whereby information (message) is sent from one person (sender) through a channel to another (receiver) who in turn reacts by providing feedback". (Fazey, I.H, 2005) Communication is, therefore, a dynamic process involving a continuous flow of information from one person to the other. Hence, present day nursing needs from nurses to possess knowledge together with awareness of globalisation. Computer and telecommunications technologies made many new structures and communication systems possible. In order to deal with change and turbulent environments, nurses must incorporate communication mechanisms to ensure proper co-ordination. "Relational communication" refers to the alignment of the practice’s structure with motivational strategies and leadership so that it nurtures an informal communication system that promotes the environment (Conrad and Poole, 2002). The nursing professionals work together through trust, commitment and open communication systems. Their work is coordinated through communication and co-operation rather than through authority. Many practices, however, are a pastiche of more than one of these strategies (Conrad and Poole, 2002). These days communication skills in any service work are essential at every level. For example, in developing countries particularly communications are crucial for forming linkages among small, medium and large hospitals and developing an integrated economic system in this way. When linked with other surgeries in the domestic economy, large hospitals can provide a market for the intermediate production of goods from smaller industrial firms (Spring and McDade, 1998:15). In growth-oriented practices, it is also the responsibility of nursing management to help nurses engage in dialogue (McDaniel, 1997: 21-31), which highlights the importance of managerial skills in present day practice environment Managerial skills were needed in the past too, however, in modern scenario Management is considered as more rational process that deals with the use of scarce resources and tasks such as planning, organising, leading, co-ordinating and controlling for attaining certain objectives through most modern ways within practice environments. (Marx, Van Rooyen, Bosch and Reynders, 1998: 349). Although management and leadership are related, the two concepts are not identical. Often, leaders with entrepreneurial abilities can start a successful practice, but when the practice grows, they may fail as managers. Usually, a nursing manager is highly skilled in management through predetermined structures. (Marx et al., 1998:708) In most modern practice environment a typical nursing staff needs to have high efficiency, together with some degree of managerial skills, as both proves to be essential in long run. (Pierce, S, 2003) Like old times, it is the responsibility of nursing management to help staffs engage in dialogue in present day practice environment too (McDaniel, 1997: 21-31). However, for venturing and further growth, enhanced information and organisational communication systems are crucial. In addition, differences of opinion are also encouraged. Now days, potential nurses are encouraged to have some previous experience and qualification of nursing too which proves to be highly valuable in order to start an employment, as are perseverance and communication skills are needed to obtain feedback from patients and co-workers. Managerial skills are required to maintain the balance of operations. For further growth in an environment, however, leaders need to create new approaches and explore new ideas to cope with most modern medical advancement. (Zaleznik, 2007, 130). Research carried out on facilitators of organisational innovation indicates that strong leadership is considered to be more important for further growth in a modern day firm than the past (Dollinger, 2005). In current scenario, if Leadership skills are strong, it will create the environment for innovative solutions. If the leader's view makes sense and seems honest and credible, employees will automatically approach new situations through the leader's frame of reference (Conrad and Poole, 2002:123). On becoming a nursing staff in a most modern practice, one needs technical skills, perseverance, communication skills, the management of processes and leadership to persuade others to follow a vision. However, leadership is not only required to lead a firm like previous times, but now it is also required for further employment growth that requires innovative solutions to challenges. (Spring, A. and Mc Dade, B.E. 1998) ‘Innovation brings change (Timmons, 2007, 30) and creativity brings into existence something that has never existed before or disturbs the status quo’ (Jennings, 1994: 287). Joseph Schumpeter (cited in Jennings, 1994) describes employment as the process of creating new combinations of factors to bring employment and organizational success both. Schumpeter also remarks that innovation by employees may take the form of reconfigurations, and need not be the product of brand-new ideas. The creation of a market may not represent a new idea; it may simply be a different approach for the particular industry that provides a competitive edge. A common channel through which technological innovation makes its way into an employment is through relations with other employees in a firm. Innovative employment innovates by the form of the acquisition of tools and equipment or the exchange of ideas from other employees (Zaleznik, 2006, 68). In modern day environment, only a limited number of nursing staffs grow to become Managers. Some do not have the desire or ability to pursue growth opportunities or manage growth. Growth brings about change, and employees that have an employment spirit should have the willingness to change and grow (Stelzer, Irwin, 2008, 35). Unlike past, present day businesses encourage feedback from the environment and communication with other co-workers that helps to keep a competitive advantage. Managerial skills help to facilitate communication, but are also required to maintain the balance of operations. New ideas are born by keeping ahead of customers' needs, a situation that relies on pro-activity. (Shuman, J. 1999) A very new concept is Pro-activity. In a nursing employment sense it is the "willingness to be first in the introduction of a new concept or idea rather than respond to the actions of competitors" (Stelzer, Irwin, 2008, 35). Unlike past, Service work in a growing medical practice now require frequent changes, and attempt to change in a manner that is creative and innovative. Thus, pro-activity is required for growth. Bob Reiss, another expert, is also of the opinion that a practice has to keep one step ahead of patients' needs (Tiffany, 2000). In a 2005-6 survey of 700 surgeries, practice owners were asked to describe the most important attributes desired in job applicants to cope with most modern changes. The top six qualifications identified were oral communication skills, written communication skills, interpersonal skills/ soft skills, proficiency in field of study/technical competence, demonstrated teamwork ability, and demonstrated leadership ability. (Reynaldo, J. and Santos, 2008) Together with other skills, team effectiveness is now considered a basic workplace skill for nursing. (Warner, 2005, 230). If nurses are to realise their potential for improving organisational outcomes, team effectiveness and communications skills must be well developed. Basic knowledge of problem-solving skills is also helpful for employees. (Porterfield, S.C. and Forde, C.M. 2001) Skills of identifying and working through problem situations are essential in the period between assignment of the task and performance. Too often employees, upon encountering problem situations, immediately seek the facilitator's assistance in resolving conflicts. Having skills to identify and work through problems themselves can be just as beneficial and meaningful to learning as goal attainment. (Davis, L., Riley, M., and Fisher, D.J. 2003) Hence, Modern day pratice environments give more opportunities to nurses, to combine educational theory and professional guidelines to perform and improve nursing skills than in the past. Nurses must assess what they learned, the method they employed to learn it, what obstacles they encountered, how they overcame obstacles (if they did), and if not, why not. Nurses should also assess whether the process or method they used to achieve a particular task was the most effective and productive. Modern day practice environment allows nurses to reconvene as a group and discuss conclusions, findings, and recommendations from the evaluation process. References Bellandi, M. 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